Cheeks are uneven and smile lines and marionette lines are already shrinking after 2 weeks. What can I do to fix this? (photo)

Question

I have spent $5000 and on filler over the last two months. 3 plus syringes of voluma for smile lines and 3 syringes of vol bella for the marionette lines of which half syringe of volbella was used for forehead crease.

Elham Jafari, MD · Answer

Hi and thank you for your question! The best and most accurate assessment can be done by your physician, comparing your current results with your baseline pictures taken before doing any treatments. Uneven results can be adjusted after two-weeks (to make sure any residual swelling is completely gone). Also, sometimes when the swelling is active, it adds to the volume and as the swelling is going down, some patients might think that the treatment results are shrinking, while the filler is not really changing and it is the swelling that is going away. Again, nothing can replace a follow up with your physician who can address all your concerns. I hope it helps and good luck!

Jason Emer, MD · Answer

It takes 1-2 weeks for swelling to resolve after injections. If you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique. For these areas, I recommend fillers for the lines themselves but also lifting around the mouth and cheeks to build underlying anatomical support. In our practice we combine sculptra with other fillers "layered" on top and lasers, rf treatments, J Plasma and peels to get the most conservative natural look. Please see a facial sculpting expert. Best, Dr. Emer

Heidi A. Waldorf, MD · Answer

Your filler is still there.  The 'shrinkage' you describe after 2 weeks is likely a result of your initial swelling disappearing.  Although it is impossible to judge exactly with the photos posted, they do show significantly filled nasolabial folds and marionette lines.  My recommendation is that you return to your physician and ask her.  Review your before and after photographs -- we often forget exactly what we looked like before.  And discuss your expectations with her to make sure that you are both on the same page.  I hope this answer was helpful.  Best wishes.

Kouros Azar, MD · Answer

It takes two weeks for the swelling to subside so what you refer to as "shrinking" is really just the results of the swelling diminishing. This leads me to believe that you will be happier with a touch more filler so contact your injector. It is always best to start with a conservative approach as it is much easier to add more filler than to take it away.

Cheeks are uneven and smile lines and marionette lines are already shrinking after 2 weeks. What can I do to fix this? (photo)

Answers (4)

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