Thank you for your question. Voluma is a wonderful product for enhancing the cheeks and midface. None of those treatments you mentioned caused the Voluma to dissipate. What is much more likely is that you simply did not get enough Voluma at the initial treatment. In the FDA trial, the doctors had unlimited syringes of Voluma to use. In fact, the average was over 6 cc per patient. Additionally, all patients were offered a touch up procedure at 1 month. 60 % of the patients did a touch up and the average was another 2 cc. In real practice, I have never injected that much Voluma into a patient. We do tell all patients that we want to reevaluate them at 1 month. At that time it is likely they would need an additional 1 or 2 syringes depending on the correction and look they are desiring. I frequently inject 3 cc total on the first injection session (1.5 cc per side), but this has varied from 1 cc to 4 cc. Every patient is different. At your follow, I would recommend discussing your concerns and desires with your physician. Hopefully, in the end, you will be as happy with the product as I am.
In general, I find Sculptra to be a higher volume filler that lasts consistently longer than any other non-silicone filler on the market. One vial of Sculptra = 8 ccs vs one vial of Voluma = 2 ccs. It is also more cost effective for patients requiring a high volume filler. Hope this helps.
Voluma should last up to 2 years, although the results do vary to some extent. at 1.5 months post treatment you should definitely still have an effect. it might be that you actually need more - in the clinical trials the average number of vials injected was 6. perhaps in the early post-treatment weeks you enjoyed some 'volume' related to swelling. it is unlikely that anything you did caused this. i'd return to your treating doctor and she what he or she says. good luck.
The original FDA approval trial indicated that Voluma can last up to two years. Of course every patient will have their own experience. In the trials patients received on average 6 syringes. It may be that 2 syringes was not enough for full correction in your case and that the initial change was partly swelling. Check with your physician and see if you need a bit more to get the result you want. Things like exfoliating brushes, red light or other HA products should not diminish results.
Please discuss this with your doctor. The results immediately after injection can be enhanced due to swelling, so this may be a factor. One cc per cheek is a relatively small volume, so it is possible you where undertreated.
The new Juvederm Voluma XC is a very natural volumizing injectable that we get consistent beautiful results with. The problem you may be having is that you didn't have enough. Although Voluma is very effective and can last up to 2 years, it can take 5 or even 6 cc's for a patient to get full correction and have the lasting effect. Now that you can see how pretty the effects of Voluma can be, I would say go for the full correction and you will benefit for 2 years with that pleasing result you had in the beginning.
Voluma is a relatively unique hyaluronic acid filler with physical characteristics that allow it to retain its shape and form. When placed in a restricted space such as directly over the cheek bones, lifting of tissue can be accomplished with a relatively small amount of product. Filling in a large hollow under the cheeks generally requires more than 1cc per side. You might just need more. The effect you saw initially could have been in part due to swelling from the trauma of the injections. Agree with Dr. Peck about Sculptra, you simply get more volume when filling severely hollowed cheeks. One warning however, Sculptra treatments carry the risk of nodule formation and cannot be reversed.
I have a number of patients who add additional Voluma correction after their initial treatment.
After the original swelling disappears, some people are satisfied with the amount of correction and lift they get while others want additional lift.
It's not anything that you are doing that "decreases" the effect, just a settling of the original product and the realization that you need more than you or your doctor thought.
In any case, I feel it's better to add more later than overcorrect initially.
Thank you for your question. An in person evaluation is required to make an accurate assessment. 1 syringe of Voluma is a fairly small amount of product, you may require additional product to obtain the desired look.
Please follow up with your injector.
Voluma is a form stable volumetric filler that is indicated for the cheek region and is injected in the deeper tissue for mild to moderate midface aging. The result about 2 weeks after the injection will still have the procedural swelling as well as the product absorbing water in the tissues. After about 2 months, this will dissipate and if needed, a touch up may be indicated. It is always easier adding product rather than removing it.