Voluma for eye hollows? Should I be worried? Office exclusively recommends Allergen products/fillers? Is this a huge red flag?

PS only recommends Allergen fillers in general, claiming these are best. No Restylane, Belotero, Sculptra, etc., etc. Said Voluma (combo w/ActiveFX) would correct mild under eye hollows; this "solution" has been anyrhing but. Is a softer filler (Restylane, Belotero) a more appropriate injectable for this soft tissue/thin skin area? Is Belotero better when considering Tyndall effect? Should I run from a practice that deals exclusively w/Allergen? Is this fishy &/or potentially irresponsible?

Doctor Answers 7

Tear trough filler

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I prefer Restylane or Belotero for tear troughs... Not Allergan products.  

My best,
Dr. Nazarian
@drsheilanazarian on Instagram

Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Best Eye Fillers

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There are many practices that only use Allergan products but I would personally find this very limiting.  I inject all different types of products since different companies offer various types of fillers.  Galderma offers Sculptra and the Restylane brand of products.  Merz offers Beletero which is idea for the under eye area.  Please consult with a board certified dermatologist with expertise in these various fillers.  Best, Dr. Green

Allergan products are excellent, but there are alternatives

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Allergan produces excellent fillers.

for the under eye hollows, I prefer restylane silk myself.

you may want to explore other non-allergan products with providers that offer those.  But there is nothing wrong with a practice that wants to use only one kind of products.

Good luck

Marwan R. Khalifeh, MD
Chevy Chase Plastic Surgeon
4.7 out of 5 stars 107 reviews

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Office exclusively recommends Allergen products/fillers? = Humm #fb #fillers #patient #drmesa

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All the US FDA approved fillers base have passed all the test to be safe and effective for their indicated use as well as other off-label use. The fillers are made by several companies including Allergan.

Allergan products like voluma are excellent, but it doesn't mean that other company products like Restylane or belotero are "inferior" than Allergan products. It depends for what they are use. For example, Voluma is excellent better than restylane for cheek augmentation in my experience, but for tear through treatment, Restylane and Belotero are better than Juvederm and Voluma. For fine lines, Belotero is superior to all the other fillers. All fillers companies have "frequent flyer programs" so the more you by from them as a physician the cheaper the cost of the product. That's why in some practices some practitioners exclusively use one company for all their fillers.

In my office I use fillers from all companies. For my office is more important patient satisfaction and giving the best treatment available to a patient that marrying to a single product company for additional discount in product cost. 

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 141 reviews

Voluma for under eye hollows

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Thank you for your question.  In regions where the tissues are thin or soft, I tend to favor products like Restylane or Juvederm.  For under eye hollows, I usually favor Restylane as it is more predictable in my hands for this region.  There are many practices that offer only one brand of products/fillers while others carry a portfolio.  I offer a multitude of products and use them differently based on injection area, patient goals and whether a patient has a specific brand preference.  

Voluma for eye hollows? Should I be worried? Office exclusively recommends Allergen products/fillers? Is this a huge red flag?

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Hi Shortcake83,

There is nothing wrong or illegal from a physician to utilize what he believes works best in his hands. I think that there is a lot of misunderstanding and confusion on what filler does what from your part. I went back to your profile and you have 18 questions about this subject in 13 days. I suggest that you return to your injector and revisit what you discussed with him/her. If you float from consult to consult, opinion to opinion, you will get even more different perspective and answers that will only add to your confusion. This is the reason I believe that you are having all this misunderstanding, you are collecting too much information that is based on specific medical anatomy, physician experience, websites, special situations, etc. and you are trying to apply it from the patient point of view in a general and absolute manner. You will only get frustrated this way.

If you have a second opinion physician that is advising you that another physician is using "exclusively" a brand just to improve their tier, I would be worried about that second opinion physician trying to throw under the bus your original physician.

As an example, in my practice I recommend primarily the Juvederm family of products because as compared to Restylane I believe that Juvederm is a superior product (this is the reason I do not carry the Restylane products). There are many practices that beleive the opisite, and there are practices that have all of the products (like Baskin Robins). There is only one benefit that Restylane has over Juvederm, that is Silk. Restylane Silk and Bolotero (Merk) do better on the lower lid hollow. From Restylane Silk vs. Bolotero, I prefer Bolotero and it is what I use on my patients and have available at my office. I also carry Radiesse that can be used for the cheek, angle of the jaw augmentation, but when compared to Voluma, Radiesse is more lumpy and it can't be reversed.  I utilize Radiesse for back of the hand rejuvenation. I do not offer Sculptra because of the nodules and complications that have been reported and also it is not reversible.

I do not think that Voluma and ActiveFX could have been recommended to you as a "solution" for correcting mild hollows under the eyelid. Most probably you had injections of Voluma to your malar area to improve the heart shape appearance of your face and ActiveFX to improve on wrinkles of your lower eyelid area. Then Bolotero or Silk could be used later to improve on the hollow of the lower lid. Procedures can be staged at different times, but you will have to wait until all procedures are completed in order to obtain all the benefits.

Tyndall effect is only seen when a filler is injected too superficial. Bolotero in my opinion has the least of this problem. But for the area that you want the injection (lower lid hollow) this does not apply because you are not injection into the skin, you are injection into the softer tissues below the skin or below the muscle.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, used against any physician or as medical witness expert advise or court, but only opinion. This answer is for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. Seek in-person treatment with a trained medical professional for appropriate care."

Hope this helps,
Dr. Gus Diaz

Gustavo A. Diaz, MD
Charlotte Facial Plastic Surgeon

Voluma for eye hollows? Should I be worried? Office exclusively recommends Allergen products/fillers? Is this a huge red flag?

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Thank you for your question and I am sorry that your Voluma results have not been what you anticipated.  There is no inherent red flag for a physician limiting their practice of dermal fillers to only a few, as many will use the products that work best in their respective hands.  Allergan is a very reputable company, and the largest in the aesthetic marketplace.  With the thinness of the skin of the lower eyelids often a softer/thinner dermal filler works best to avoid noted complications, and there are a number available including Restylane and Juvederm.  Hope this helps

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.