Indentation after filler and Botox in cheek area (Photo)

Question

voluma injected into cheek, botox 2 weeks later, has left crescent mark and indentation. Feeling sick with anxiety, please advise.It was meant to lift and fill and I look so much worse.There was no mark or dipping beforehand. Will it revert in time after filler and Botox. There are scary stories on here, and I don,t want to dissolve because of risks of fat loss

Elham Jafari, MD · Answer

Hi and thank you for your question! If it has been at least 2 weeks following your last treatment, it would be best to do a follow up with your doctor. The indentation is easy to fix with some additional filler injections and/or removal or adjustment of a bit of the filler with enzyme injection. It is not uncommon for patients to needed further revision following filler injection. I hope it helps and good luck!

Melvin Elson, MD · Answer

After cheek augmentation you could have an indentation occur from the elevation of the area and then accentuated with the Botox. None of this is permanent but can be improved with injection of filler into the area. See an experienced dermatologist for a consultation

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question calum. I understand your concern. Botox is a purified
protein used to address wrinkles associated with facial expression. Voluma is an injectable filler used to enhance the appearance of the mid-face. It is difficult to make an assessment without before photographs. When a filler is placed in the cheeks it will provide volume to the area. Sometimes this gives the appearance of a deficit or dent in the adjacent area. In these cases more product can be added to fill such deficits. Fillers are not associated with a risk of fat loss but hyaluronic acid fillers can always be dissolved an re-injected if the desired results are not achieved. Please
consult with a doctor for specific recommendations. Good luck!

Andre Levesque, MD · Answer

Thank you for your question and photo.
I am sorry you are experiencing this sub optimal result. The good news is Botox and Voluma are totally reversible with time.  The Voluma could be dissolved with injection of hyaluronidase however I would encourage you to see your injector as they would certainly be interested in helping you through this issue.
From your picture I can't totally tell if this is present at rest or during animation.  The solution might be more time, injection of hyaluronidase,  or injection of the more superficial filler in the area of depression. Seeing your injector will give them the opportunity to discuss your options. If you're not happy with their explanation seeking another in person opinion with a board-certified physician would be a good option.
Best Dr. L

Tom van Eijk, MD · Answer

There are a great many excellent doctors in the UK you can see you and solve this. If the crease only appeared after Botox it will disappear by itself. If Voluma is causing it, removing the substance with hyaluronidase is not something you should fear. It does not, can not  dissolve your own fat. If you are too afraid to dissolve, strengthening the skin by superficial injections can reduce the fold.

Lawrence Bundrick, MD (retired) · Answer

Some additional filler should be able to correct this indentation for you and give you the desired results.

Indentation after filler and Botox in cheek area (Photo)

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