More pronounced jowls after Juvederm Voluma?

Question

I had Juvederm voluma (2 units) for my sunken cheeks done a week ago. I am very happy with results, my cheeks look much better, I had no bruising and just very mild swelling for about day or two. However, I noticed that my jowls got saggier/more pronounced. Is this common? Could it be that I still have some swelling or ...

Michael I. Echavez, MD · Answer

Whenever a filler is used in the cheeks, it is important to not place the product too low, or it can give the appearance of jowls.  It is definitely possible to get swelling in the jowl area after a cheek injection though, even if the filler was not placed too low.  Since your treatment was only a week ago, I would wait another week or two to see how it looks.  Most likely, it will improve with more time, but if you feel it is not you should return to the physician who treated you to be evaluated.

Jason Emer, MD · Answer

Where voluma is injected is where it should stay.  You can get swelling from hydrophilic HA fillers like voluma (although it typically is less than with others) and this may be what you are seeing.  However, a formal consultation is needed to determine if other procedures would be better for you.  Best, Dr. Emer.

Stephen Weber MD, FACS · Answer

I have seen this once in a patient who consulted me for a second opinion. This could still be swelling but that is unlikely. My suspicion is that if filler was placed in the buccal fat pad it could have migrated lower in the face. This is unusual but could occur if filler is placed in the fat pad as opposed to on the periosteum. Regardless, if it does not resolve on its own it can be corrected with hyaluronidase. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Mariusz Sapijaszko, MD, FRCPC · Answer

As with any cosmetic filler treatment, it is absolutely critical to place the product in right location. When cheeks are treated, some of the product can, inadvertently, be placed lower then intended and than can result in some lower cheek fullness.Please see your doctor back and see what can be done.

Michele S. Green, MD · Answer

Voluma is a fabulous product and gives an instant lift for the cheeks.  However, if any product is placed too low you could have swelling or product in the jowls area.  If it seems that the filler looks unnatural you should return to your treating physician to have the product dissolved by Vitrase.  Please consult a board certified physician with a great deal of experience with Juvederm Voluma for the best results.

More pronounced jowls after Juvederm Voluma?

Answers (6)