Volumizing with Filler, Sculptra vs Voluma
The most important choice is not the type of filler, but the doctor administering it. Both products can be used for volume. I prefer Sculptra for large volumization because the patient's look more natural and has a longer result. It is also less expensive because a vial of Sculptra corrects about what 4 cc of Voluma would do. Sculptra can be used the same day as hyaluronidase is used, unlike HA fillers. With an experienced injector, nodules shouldn't be an issue. It is typical to wait about 6 weeks between injections to allow for the correction to be fully appreciated prior to placing more Sculptra.
Sculptra and Lower Face
I utilize a combination of products to use the lower face and I do love Sculptra for just this indication. It gives an extremely natural looking result with long lasting results. Voluma is great too for mid-face injections with beautiful results.
Sculptra is the filler of choice for providing full facial lifting and revolumization
Generally, Sculptra excels at providing full facial lifting with revolumization,
particularly in larger and deeply hollowed areas like the lower lateral
cheeks and temples. It can provide a nice jawline lift as well. I find
the denser hyaluronic acids like Voluma
work well above bone in focal areas like the upper cheeks, but may
appear too heavy in other larger areas with less underlying support. And Voluma becomes quite costly for larger areas of correction. It is true that previously, older protocols for Sculptra resulted in more reactive nodules, but with the new dilution and injection techniques, this problem is not commonly seen. I recommend 4 weeks between injections of Sculptra, with injections done at 6 week intervals for older individuals.
Sculptra and Other Fillers for Facial Sculpting
All of my facial volume and lifting patients get sculptra as their foundation to help build collagen long term, lift, and compliment laser and skin tightening procedures. We layer other fillers on top such as voulma or radiesse for contour and shape and fold improvement. I suggest seeing an innovative facial sculpting expert who tailors their fillers to your needs and often uses combinations to get best results. Best, Dr. Emer.
Regaining Facial Volume: More the "Who" than the "What"
It will be difficult to comment about how and where fillers/volumizers should be placed in your face without photos and preferably an examination. As far as non autologous methods of providing facial volume, I can vouch for both Sculptra and Voluma. Sculptra has been FDA approved in the United States substantially longer than Voluma and provides what I would describe as a more organic look. The problems you mentioned are well described with Sculptra and are likely related to a poor initial understanding of the product. Sculptra needs extensive reconstitution time in sterile water (5-7 days), must be injected in a deep tissue plane, and requires extensive post-treatment massage. Since Sculptra cannot be dissolved, it requires an experienced injector. Voluma also works very well and is reversible, but but provides less volume per unit cost than Sculptra. Ultimately, it comes down to "who" is injecting rather than "what" is injected. Fillers, toxins, and volumizers are becoming largely commiditized and many people opt to save a initial few bucks with a less experienced or non-experienced injector. Dissatisfaction and/or the need for correction can make this a more expensive venture.
Voluma XC Gives Immediate Results For Facial Reflation; Sculptra Takes A Series Of Treatments To Do So
Although Voluma XC is officially approved for nonsurgical cheek augmentation, it is routinely used for volumization of the lower face, as well. In fact, the patient I will be seeing in a few minutes is coming in for nonsurgical jawline straightening and nonsurgical chin augmentation, for which I will be using Voluma XC.
The desired results of treatment with Voluma XC and other hyaluronic acid based volumizing fillers, such as Restylane Lift, or Radiesse Plus, a calcium-based product, are immediate ( typically eliciting a "Wow!" response) and are relatively long-lasting, about 1.5 years.
Scuptra, which I gave up injecting several years ago, can also be used for this purpose. However, this product tend to be relatively expensive, does not yield immediate results, and requires about three separate treatment sessions--for best effect--with results usually seen in several months (since Sculptra depends upon stimulating one's own collagen and elastic fiber production). Results typically last about two years.
In my opinion, the slight difference in duration achieved with Sculptra is offset by the fact that it takes considerably longer to realize benefits, as well as its expense.
Best to discuss this with a board certified aesthetic physician with experience and expertise in lower facial augmentation. Make sure to ask to see his/her before and after photos.