After Juvaderm Voluma in my Cheekbones, Swollen and Uneven Face

48hours later im starting to freak out still swollen in my left side but i can still easily see she misplaced the product plus giving my left side much more 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 24

Don't Freak Out -- Ask Questions!!

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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 17 reviews

Voluma injections require an artistic eye.

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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 36 reviews

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

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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.

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

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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
4.9 out of 5 stars 33 reviews

Communicating with your provider

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As an experienced provider of injectable fillers, I can attest that it is a safe and effective treatment when applied by a trained professional. While it takes up to 10 days for the swelling to go down, depending on the area, the results are long-lasting. Most clients need 1-2 syringes for a dramatic effect, but some require more. This depends on the amount of product you need to achieve your desired look. Any facial enhancement requires a great deal of precision and skill and can really alter the balance of your face when done poorly. Be wary of pricing that is overly discounted. If you have questions or concerns after your appointment, it is recommended that you contact your provider as soon as possible! Best of luck!

Justin Harper, MD
Columbus Physician
5.0 out of 5 stars 24 reviews

Do What You Think Is Best

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The patient can experience a small amount of swelling for 24 to 48 hours after the injection.  There is always a slight chance of bruising in the treated area. . Try to avoid any contact to your face to shift the product underneath the skin. Facial cleansing is to be continued just do not apply hard pressure to the area of treatment for 48 hours.

David L. Robbins, MD, FACS
West Des Moines Plastic Surgeon

Swollen and uneven after Voluma

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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,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Voluma can draw water to it

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Swelling can and does occur after voluma- because this filler can absorb water. This swelling usually lasts a few days but in rare cases a few weeks. It almost always goes away/down. Uneven contours can be touched up with more filler, if necessary. You can always let your doctor know that you feel there is some degree of unevenness- he/she can easily correct this. 

Sameer Bashey, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 9 reviews

Good move in asking questions…

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I understand that this may be a little scary for you, but I commend you for asking questions to better understand the situation that you are in. Here goes…

Patients who have undergone Voluma injections, slight swelling may be experienced within a day or two after the treatment. There may also be slight bruising in the injection site. Along with the swelling, you may also observe bumps, lumps, as well as slight asymmetry. You may contact your doctor to tell him or her about your observations. I would advise giving at least a couple weeks for the product to settle and even out. If after a couple of weeks, you still observe the swelling and lumps and you are unhappy about it, you may notify your doctor so you can schedule a checkup. This way, you can both discuss the best course of action to manage the swelling as well as the lumps.

Robert W. Sheffield, MD
Santa Barbara Plastic Surgeon
4.9 out of 5 stars 23 reviews

Swelling After Voluma

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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 181 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.