There are a few things that you can do. A more conservative approach would be to massage the area several times a day and apply warm compresses (be careful not to burn yourself) a few times a day in order to help break the product down a little bit faster and help smooth out any lumps. In addition to the massage and warm compresses, you can just give it time to see if it improves as the product breaks down, although this may take quite some time since Voluma is supposed to last 2 years. Another option is to have the product dissolved with hyaluronidase. Contact your injector to see which is the best route for you.
Another suggestion is to have a thinner product injected at your tear troughs in the future such as Juvederm, Restylane, or Belotero. Voluma is not usually used at the tear troughs since it is a rather thick product. It is mainly used at the cheeks to correct volume loss.
Thank you for your question. It is possible to dissolve Voluma with hyaluronidase injections. Speak with your injector regarding this treatment.
One of the great things about the hyaluronic acid fillers (Juvederm, Juvederm Voluma, Restylane, Belotero, Perlane) is that they can be quickly and easily dissolved. The raised areas of visible filler could be treated with a hyaluronidase such as Vitrase, and should improve the appearance of those areas.
That being said, for superficial injections and for treatment of under-eyes, Belotero and Restylane are better options as they are less likely to be visible than Voluma in those areas.
The FDA approved Voluma for the deep layers of the connective tissue of the cheek area. It is typically placed just over the periosteal lining of the bone. This does not mean that other areas cannot be treated: most medications, including other fillers of course, are used for other indications outside of the specific FDA indication, and we all benefit mightily from that. But there is not much experience, and no studies to date, in the tear trough area. It is a very robust filler, with a high G-prime and lifting capacity, and it is quite firm and not as easy to spread around as, for example, Beletero, and, unlike Beletero, it could show if it is placed close to the skin.
It seems to have given you a good correction, but if you are not happy with it showing you will want to have hyaluronidase injected rather than waiting for it to be resorbed as the longevity of this filler is at least two years.
Voluma is designed to be injected in the deep tissue to add cheek volume. When placed more superficial it can bee seen/felt.
I recommend you discuss your concerns with your physician. One of the advantages to using Voluma is that it is in fact "reversible" with an enzyme injection.
Juvederm Voluma is really designed to be put in a bit deeper and into the central and upper cheeks. It's not a great filler for the majority of people into the tear troughs. If you don't like it, it can be removed with hyaluronidase. That and time are the options to remove it.
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