Please wait a couple of weeks or so before assessing your results. At the moment, you results are obscured by swelling.
Thank you for your question.
You may find more of a difference when looking at your profile. The product was placed in the front of your cheeks and therefore when you take a photo straight on it is difficult to see. Wait 2 weeks and assess, schedule an appointment with your injector to view before and after photos. At this time you can determine if additional treatment is required.
Two syringes should provide you significant improvement. However, you should allow a week to ten days for the swelling to diminish before attempting to evaluate. Your injector should evaluate you in about a month to evaluate the progress.
It is hard to tell with your limited photo angled shots and because some degree of edema and swelling occurs in the days following your injection. You should see a noticeable difference using a vial on each side. Wait a few weeks to determine if more is needed. In general Voluma is not used immediately below the eyes as thinner less viscous fillers have an advantage.
I think you definitely have a nice improvement in your cheeks even though a 3/4 facial view would be better to assess this. 2 syringes of Voluma is a reasonable initial treatment. You should not try to evaluate the results of your injection too soon; however. Keep in mind that other fillers are better for the tear troughs (circles under the eyes) like Belotero or Restylane, but I would wait 2-3 weeks before treating that area as the swelling from your Voluma injection needs to subside. Be sure you see a "core" injector (facial
plastic surgeon, plastic surgeon, dermatologist, or occuloplastic
surgeon). This is because we all have a keen understanding of facial
anatomy and the effects of injecting Botox/ Xeomin/ Dysport and fillers
regions of the face. I wish you well!
The amount of Voluma depends and two factors: the degree of "hollowness"/volume loss in the area and where the aesthetic endpoint is for the patient (and injector). Remember, Voluma and also Juvederm Ultra syringes contain only 1.0 ml (milliliters) of product, and for reference 1.0 ml = 0.2 teaspoons (in other words 5 ml = one teaspoon).
Typically, with the degree of volume loss illustrated at least 2 syringes of Voluma is required to achieve what most people would consider an aesthetic result or "significant " difference, although some may feel 2.5 to 3 syringes per side would look better for their facial shape, with some of the product going lower in your cheeks (i.e., submalar or buccal area). However, spacing the treatments (one syringe each time) over a period of time is always a good option, with the wait time being 2-4 weeks.
I hope this helps
There is definitely a noticeable improvement in your cheeks. Whether you require more or not will depend on your goals at this point. If you want your cheeks to be even fuller then I would recommend adding some more Voluma until you reach your desired results. You may also need some filler to your tear troughs and nasolabial folds to make your facial transitions smoother. This can be decided in consultation with your injector.
You really can't see any change? I understand you having bruising and swelling, which is quite common after any fillers, but I definitely see a change in your cheeks. If you want your cheeks fuller then yes, you will need more Voluma added. One syringe per cheek is a good starting point, but some people do need more.
"This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."
Voluma is a great product that is the only FDA approved filler for immediate lifting in the mid face. Even when injected only in the mid face, the positive effects at eliminating eye wrinkles can be seen. There can be some swelling after any injections. I would wait about one week to assess the true results. For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with Voluma.