Dr. Marwan Khalifeh: Juvederm Voluma has been something that's been in the works for a long time and there are plastic surgeon and facial plastic surgeons will be invading for it to get up for your group. It just got FDA approved in the United States very recently and actually there's a very few people that have this and operate. There's only a handful of facial plastic surgeon and plastic surgeons in the DC Metro area have the Juvederm Voluma. As one of their clinical instructors for the company, Allergen where I go around and teach other doctors and dermatologists and other nurse injections how to do injections, I was privileged enough to be able to experience this and be able to offer to my patients a little bit ahead from everybody else. So our experience, I'm going to share that with other doctors, other injectors and also for patients who are interested in seeing how this works.

Now, it comes in a package just like the other Juvederm that we've been used to; two syringes, 2 worth of cc in this per package. It's got a really nice packaging of all Juvederm. It comes into XC form which has lidocaine mixed in it. The lidocaine mix is a little bit more comfortable as the injections are done. It's a hyaluronic acid just like the other two Juvederm that's cross linked in a way that it is meant for deep injections and its FDA approval is for cheeks, basically for instantaneous augmentation of the cheek. So for people who are looking for a little bit of augmentation, a little higher cheekbones or who've lost volume in the area below the cheeks and want that youthful triangular that youthful heart-shaped face, this is fantastic. This is not meant for superficial lines. This is not meant for lips and I say that again. Do not put this in the lips. This is not meant for tear troughs.

Please, please, please, don't put this in the tear troughs and I've seen people put Artefill and Radiesse in the tear troughs. That should just never happen. This also should never be placed there. It's for deep injections on top of the bone and it does a fantastic job of augmenting that area. It's supposed to last about a couple of years but like any other filler after a portion of it dissolves in about six months to eight months to a year anywhere around there, you want to replace some of that lose so that you maintain a certain look. You don't want to keep yow young up and down and I'm going to demonstrate the injections. The injections are transcutaneous. You can go intraoral as well but I think the intraoral injection places a little bit higher risk of inaccuracy, misplacement and even potential injection.

The transcutaneous route can give you some bruises, but it's one of those things that you prepare for. We give our patients arnica, pineapple juice, bromelain. Make sure they're off of any things that thin the blood like flaxseeds, fish oil, omega-3, gingko, Echinacea, all those supplements. Any contact with seed supplements will actually make your blood thinner and make your bleed more. So we have people avoid that for about two weeks before and I'm going to demonstrate the injections.

All right. So it's important to analyze the cheeks. It's a very broad term. What does cheek mean? There're multiple zones to the cheek. They are mid face area or the anteromedial cheek. This is one part that a lot of people started losing especially people that needs tear trough injections. They need volume here. She doesn't really need much volume here. You could see that she's a little bit fuller on this side versus this side, so maybe a couple of drops over here. The most important thing is to understand 85% of the people have significant facial asymmetry. The other 15% have it to a certain degree. Nobody is perfectly symmetric. Perfect symmetry is impossible but you got to have the eye and know where to inject these things. So we don't want really any injection here whatsoever, none here.

Perhaps a few little drops here. Then we talk about the malar area or the actual cheekbones and her cheekbones are okay, but we can augment that a little bit more to give her a little bit more of a lift there. Going in, going down to the bone. I'm hitting bone right here. I'm filling the bone and I'm placing a few little drops right there and you can't just see it lift up, just that little injection. You can actually see this that it improved that contour. Here, I'm going down to the submalar area again. There are some big blood vessels here but unfortunately nobody can see them. So it bleeds, don't panic, just hold some pressure. You may have to hold the pressure for up to a minute or so but it does a nice job. You can see it starts filling up here. Remember we talked about a few drops here. Definitely nothing down here, but a few drops here. So let's go up here. Are my hands blocking of you or are you good?

Female Voice: No, I'm good.


Juvederm Voluma for Cheek Augmentation

Dr. Shervin Naderi demonstrates how to inject consumers with the new Juvaderm Voluma product specifically designed for fuller or higher looking cheeks. He also notes several areas in which this filler is not to be used.