Adverse reaction to Voluma after 6 months.

Any injectable filler including voluma has side effect risks associated with its injection. One of the side effects is migration and possible lumpiness. Hyaluronic acid based fillers like voluma have the advantage that they can be reversed with the use of an enzyme called hyaluronidase. This enzyme can be injected in the area where the filler needs to be dissolved.Voluma "melting" could require from a single to multiple injections of hyaluonic enzyme. In my practice, I had to inject hyaluronidase more that 3 times ( actually like 10 times) on a  patient that had unpleasant result with hyaluronic acid injections in the face with another injector. The number of hyaruronidase injections required to achieve success depends on physical exam (until the filler has been clinically dissolved)

Thank you for your question.Injecting under the eyes is a very dangerous area.  The skin is thin and things like this can happen. At this point I would avoid any further injection to try to dissolve what is there.  All the injections can cause further irritation and possible scar tissue.  I would recommend massage daily, until the product is gone.  Good luck.

Voluma is an excellent alternative to currently used fillers. We use it for restoring mid face volume in the cheek that had previously been difficult to enhance. We have seen great results lasting 12 months and more. I would suggest you discuss your concern regarding your prior treatment with a dermatologist that has experience with Voluma. We do use it with other fillers used in different areas. We do not use under eyes so your lumps should be checked out by a doctor. 

While uncommon, delayed granuloma reactions can be seen with any hyaluronic acid or other fillers.  If the "lump" is actually clumping of the Voluma, undiluted hyaluronidase is the best treatment.   Typically two times the amount of hyaluronidase needs to be injected for each amount of Voluma injected.  If the lesion is truly a granuloma or biofilm, your board certified dermatologist or plastic surgeon may need to use a combination of an injectable steroid and 5FU. Best of luck,Suneel Chilukuri, M.D.

Thank you for your question.  Are you and your physician sure the bumps that you have developed are due to the Voluma filler particles and are not granulomas instead?  While extraordinarily rare you can develop granulomas secondary to hyaluronic acid fillers and they can show up months to years after the filler placement.  If they are granulomas, hyaluronidase will not work and you can try a very dilute injection of kenalog to try to break up the granuloma.  I agree the eyelids are very delicate and you have to be sure as to what you are treating and injecting.  Lastly are you sure it was Voluma that was injected under your eyelids because that is a large particle size to place there, typically in the Juvederm family of products, only Juvederm Ultra would be placed in the tear troughs.  Regards, Dr. Matt Elias