After Juvaderm Voluma in my Cheekbones, Swollen and Uneven Face

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.

Hi there! Thank you for your question.I would always recommend a 2 week settle in period as some of the asymmetry may be due to mild swelling / bruising after injections. At this point ensure you have follow up with the injector to review results and decide on your plan moving forward. Hope this helps!Best wishes, Dr Rupert

Swelling can persist for several days after injection of any filler product. If there is significant asymmetry, it is best to talk with your injector. This could be due to technique, or simply due to bleeding, bruising, or swelling under the skin. In most cases, mild asymmetries will even out with time, but every patient is different.
Always see an expert physician injector.
All the best,

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.  

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.

Usually the next day after injecting Voluma you can get an initial phase of swelling then it dissipates after couple days.  Swelling can last longer especially if you have some blood underneath which will be absorbed.  I massage my patients on the day of injection to smooth out any uneven areas only if I have to.  I think it's just too early for you to evaluate whether the swelling is due to tissue trauma or the product itself.  Your doctor will be the best person to judge.  I think it's reasonable to wait another day or two, however, the swelling should not get worse.