Would placing Voluma slightly higher in my cheeks cause any problems?

Question

I want my anteromedial cheek aka "apple of the cheek" to be full and youthful but I notice that when I add filler to that area, my submalar area directly below that aka hollow also increases in volume, giving my face a bottom heavy look that I do not like. I understand there is the infraorbital neurovascular bundle above the anteromedial cheek point of injection so would asking the physician to place the filler slightly higher be problematic?

Dilip D. Madnani, MD, FACS · Answer

The presence of the 'neurovascular bundle' in the cheek is alway something to be aware of - whether you are injecting voluma or any other injectable in the cheek area. So whoever is injecting in that area will be aware and take the usual precautions. The voluma should be able to be injected to the anterior cheek and lateral cheek without increasing the submalar area- find an injector with experience and you should be fine.

Sonia Badreshia-Bansal, MD · Answer

Thank you for your question. I would recommend consulting with a Board Certified Dermatologist for best treatment plan. Infraorbital  Neurovascular bundle is not an area of injection. There's an area in the anteromedial cheek that's safe to inject and an experienced injector should know that.  I hope this helps!

Donn R. Chatham, MD · Answer

Voluma is an 'H.A.' class filler that is FDA approved for mid-face augmentation. (below lower eyelids, near cheekbone). Since it is denser than some H.A. fillers, it lasts longer & can better support soft tissue. Many people, especially those with a heritage from northern Europe, have relatively deficient mid-face structures. Even with good soft tissue in the cheeks, with aging comes descent & loss of volume. So the injectable fillers can really make a nice improvement in facial support. We have used other fillers as well such as Restylane, Sculptra, & Radiesse and each has its pros & cons. It is important to not OVER-fill with any of these and the lower eyelids region deserves utmost care & precision. An experienced physician injector can discuss your best filler options prior to this rewarding & artistic treatment.

Raffy Karamanoukian, MD, FACS · Answer

You are detailed and would require someone with advanced skills to execute the injection in your case. Our office specializes in many different types of volume fillers, including Voluma and Radiesse to this area. Best, Dr. Karamanoukian Santa Monica - Montana Avenue

Brian S. Biesman, MD · Answer

You're asking a very specific question about  the risks and benefits of various rejuvenation options.  I commend you for asking such a knowledgeable question.  I would strongly suggest that you consult with a highly experienced injector who understands both your aesthetic goals as well as the anatomy of the midface and the risks of each of your treatment options.  You can then make an informed decision as to how you would like to proceed.

John Mesa, MD · Answer

Voluma (Juvederm Voluma XC) is a great hyaluronic acid based
filler that can augment and rejuvenate the facial appearance. A voluma natural
result not only depends on the location where the injection is placed
(…anterio-lateral, etc.), but also on the skills and experience of the injector.
Voluma acts as a “liquid implant”, therefore, injectors with great knowledge of
the facial anatomy like plastic surgeons or craniofacial surgeons should be
able to deliver a great natural looking results. Patients interested in facial
augmentation with voluma should discuss this treatment option with a Board
Certified Plastic Surgeon specialized in cosmetic surgery of the face.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question. Pictures would be helpful.Sometimes the filler can be "walked" into this area without being injected directly.

To be sure what might help you, see two or more experienced, licensed
and certified providers for a complete evaluation to make sure you are a good
candidate and that it is safe for you to have the procedure.

I hope this helps.

Martin Jugenburg, MD · Answer

Thank you for your question. Ensure you are working with an experienced injector. The product should only enhanced the area injected.Best,

Stephen Weber MD, FACS · Answer

Injection in the apple of the cheek is fairly straight forward in the hands of an experienced injector. Knowledge of the anatomy of that region is critical, as you mentioned, because of the infraorbital nerve. Filler can be placed in the fat of the cheek (more superficial than the nerve) and that is the technique that I use to train newer injectors on safe use of Voluma. A cannula can also be used to layer the filler in a more superficial plane far away from the nerve. This is the technique that I've found to be most successful in that area. Please find a highly experienced Voluma injector who can evaluate your cheeks and your treatment goals and make specific recommendations for you. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Jonathan Kulbersh, MD · Answer

I commonly inject hyaluranic acid fillers above the infraorbital neurovascular bundle to give height and definition to the cheek.  The brand of filler that I would choose would depend on your skin.  If you have thin skin in the area, I personally will only use Restylane in the area.  I believe Restylane behaves the best in the area close to the eye.   If you have thicker skin in the area, you can consider a thicker filler such as Juvederm Voluma or Perlane.I inject using a blunt tipped microcannula.  I believe this technique is safer than injecting with a needle around the infraorbital neurovascular bundle.I hope this helps.

Would placing Voluma slightly higher in my cheeks cause any problems?

Answers (13)