After Juvaderm Voluma in my Cheekbones, Swollen and Uneven Face

48hours later im starting to freak out ..im still swollen in my left side but i can still easily see she misplaced the product plus giving my left side much more volume..it looks deformed as it is placed over my cheekbone leaving an unatural gap to the temples ..i will wait another 24hours but then should i correct the right with more product? or dissolve only my left side and do it again? My doctor said it was because i had damaged tissue ..but i think it was her first time with voluma.

Doctor Answers 19

Don't Freak Out -- Ask Questions!!

The first rule in any situation where you are fearful is to respond, not react.
Asking the right question might get you the response that will make you realize that a problem is not so severe, is fixable, or just happens to be within the range of normal.

Having said that, the first place to start is with your doctor.  Express how you feel.  You can even ask if it was their first time, but that doesn't mean that is the problem.  My first patients did exceedingly well.

If you feel unsure or uncomfortable with the responses, get another opinion (or two) until you are comfortable with what is happening.

Whatever you do, don't rush into "fixing" what might not be a problem.
In other words, don't bleed until you're cut...LOL

There is some swelling with Voluma and sometimes it does get misplaced, even at times by patients "playing with it"

Get the facts before you act or react.
Start with your own doctor.
Move on if you feel the need.


Elk Grove Village Dermatologist
4.9 out of 5 stars 16 reviews

Voluma injections require an artistic eye.

Placing Voluma under the skin is like sculpting, you need a good eye for symmetry and balance.  One of the best things about Voluma is that the correction is immediately visible and very true to the final result. Small amounts should be injected slowly with molding to give a natural result.  Depending on the end result desired you may need more in some spots and less in others for an aesthetically pleasing result.  If your injector is new to the product you might want a more experienced second opinion.  Keep in mind you may be one of the few who gets swelling for the first few weeks, you may want to wait as long as 4 weeks to be sure that temporary swelling is not the real problem.  Good news:  it is all fixable!

Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 31 reviews

Uneven and Bumpy: Will my Juvederm Voluma Improve 48 hours following the injections?

48 hours is too soon to evaluate your injections with this or any product. There is usually some asymmetry and lumpiness for a few days, and I wouldn't try to correct it for about a month. Reversibility is a definite advantage with any of the hyaluronic acid products, but give it time before you try to get this done.

Juvederm Voluma is an excellent product for building deficient cheeks and mid-face areas and should ultimately be smooth. I prefer to take care not to over-inject during the first session. You can always come back for another session in a month or so if necxessary.

Juvederm Voluma is Excellent for Cheek, Mid-Face & Chin Augmentation, and the nonsurgical Ten Minute Necklift

Although Juvederma Voluma is not yet available in the United States in my Upper East Side N.Y. practice, I have a great deal of experience with it in my private clinic in Israel where it has been available for the past couple of years. Unfortunately, as with so many products that have received prior approvals for use in humans by their FDA equivalents in Canada, Mexico, Europe and Israel, Voluma will very likely (hopefully) receive its FDA approval for use in the States within the next year.

Voluma is an excellent product, more robust than the current volumizing fillers, such as Perlane L or Juvederm Ultra XC, and has the advantage over Radiesse in that it can be dissolved, as can all other hyaluronic acid-based injectables, by hyaluronidase. It is excellent for areas that require real volumization, such as the cheekbone area, the mid-cheek, jawline and chin. I also prefer it over all others for my nonsurgical neck rejuvenation, the Ten Minute Necklift.

Swelling and distortion of the treated areas is very common with all hyaluronic acid products, but particularly so with Voluma. What I explain to my patients immediately after treatment (before the swelling and the bruising take full effect--which can happen in the next day or so) is that "what you see right now in the mirror is what you get again when all the dust settles," i.e. when all the swelling, bruising and redness completely resolve. I make sure to alert all patients that swelling can be uneven, so that one side can swell far more than the other, but that such distortions will resolve spontaneously in a few days. I absolutely do not retreat before three or four weeks have elapsed to be sure that no asymmetry is due to persistent tissue swelling that has been slow to resolve. And I certainly would not even consider dissolving any of the material prior to that time, as well, although, to date, I have never as yet needed to use hyaluronidase for Voluma.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Swelling After Voluma

Swelling after Voluma can be a result of the following factors

-Deep bruise- Not all bruises are at the surface and this localized swelling can take weeks to dissipate

-Injection technique- Injections of the product can create depositions which can create lumps if not properly transitioned.  Since Voluma is not hydrophilic (does not tend to absorb water), Voluma tends to be a what you see is what you get type of filler.  

Consult your treating physician for the best course of action.  

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 144 reviews

Swollen and Uneven After Voluma

With the initial swelling post Voluma treatments, there can be lumps, bumps and asymmetry. Contact your injector to let them know what you are experiencing. Give it at least 2 weeks for things to settle down and even out. If at that time you are still unhappy with your results, let your injector know and they can determine if more product would be beneficial or if dissolving the product would be an option for you.

Voluma Results

It is common to experience mild swelling, bruising and pain three to seven days after receiving a dermal filler treatment. However, it should be even and have a smooth transition providing a natural appearance. My recommendation is to schedule a follow up appointment with your injector to address your concerns. Keep in mind that injecting is an art form and it is best to pick a provider based off of their expertise.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 20 reviews

Voluma

As people age, the cheek area loses volume, making the cheeks flatten out and the skin droop and sag. Voluma is a hyaluronic acid filler that is approved to temporarily correct age-related volume loss in the cheek area. It instantly provides smooth, natural-looking results that last up to two years with optimal correction. Most of my patients have been very happy with their results using Voluma, even given the higher cost for this filler. The biggest side effects have been bruising and swelling which may last a couple of days or up to a couple weeks.

Voluma inections and swelling.

Hi there, that does sound stressful. It is not uncommon though to have swelling after Voluma injections, they are placed very deep and can cause surprising swelling, even on one side more than the other. This usually goes down, but can take a week to 2 weeks, but likely within a week. You can sleep on several pillows, and sleep on your back propped up. Take ibuprofen, if you otherwise have no health issues or contraindications. If after time has passed and you still see asymmetry definitely follow-up with your doctor and see if massage can help, or if additional filler needs to be placed in the other side. If there is asymmetry I would favor the option of putting in more filler to correct as opposed to dissolving fillers, because it is difficult to control fully how much product is going to be dissolved, and this would be a waste of filler. That being said, give it some time, and hopefully this is all just secondary to swelling from the trauma of injections.

Kaleroy Papantoniou, MD, FAAD
Great Neck Dermatologic Surgeon
5.0 out of 5 stars 24 reviews

Voluma and Side Effects

Voluma is a great injection but results like all facial injections are dependent on the injector. If it looks uneven I would definitely return to your treating physician. If you feel that the physician is inexperienced please consult a board certified dermatologist. Voluma can be dissolved with hyaluronidase so try not to worry and have the situation corrected. 

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.