Facial Augmentation with Voluma
Juvederm Voluma™ FAQ
Juvederm Voluma™ XC injectable gel?
A JUVÉDERM VOLUMA™ XC injectable gel is the first and only filler FDA-approved to instantly add volume to the cheek area. It gives you a subtle lift, helping to restore contour and a more youthful profile, for up to 2 years, in patients over the age of 21. It’s different than JUVÉDERM® XC and works on a different area of the face. JUVÉDERM® XC smooths out moderate to severe wrinkles and folds around the nose and mouth, like parentheses. JUVÉDERM VOLUMA™ XC, however, adds volume to the cheek area. Dr. Klausner has received extensive training and is certified in this new and exciting procedure!
What else should you know about JUVÉDERM VOLUMA™ XC?
First and only Hyaluronic Acid (HA) filler FDA-approved to instantly add volume to the cheek area, resulting in a subtle lift Clinically proven to last up to 2 years with optimal treatment Juvéderm Voluma XC is a gel that is injected into the cheek area to gently lift the skin and restore volume that is lost from aging. It is made from a modified form of hyaluronic acid which is a natural complex sugar that occurs within our bodies. What is Juvéderm Voluma XC indicated for? Juvederm Voluma is the first and only FDA-approved non-surgical option to instantly correct age-related volume loss in the cheek area in patients 21 and older. Juvéderm Voluma has been used in Europe since 2005 and approved in over 60 countries with over 500,000 syringes used.
How is Juvéderm Voluma XC actually used in treatment?
Juvéderm Voluma XC is typically used for restoring cheek or mid face volume loss and also to help restore a more youthful curve and position to the higher area of cheekbones in women (not men). In Europe and Canada Juvéderm Voluma has been widely and very successfully used for off label FDA uses for lifting, volumizing and recontouring the face and jawline. Injection using little blunt microcannulas in addition to traditional small needles is also widely used for helping create a natural look while minimizing discomfort and bruising.
What makes Juvéderm Voluma XC different from other dermal fillers?
Juvéderm Voluma was specially designed to fill and lift the mid-face and cheeks. It uses a new advanced technology from Allergan which is called Vycross that results in a smooth gel that flows easily and consistently and which can be nicely sculpted. This special cross-linking technology not only produces the lift and fill that is unique to Voluma, but it also contributes to its long-lasting nature.
How long does Juvéderm Voluma last?
Up to two years with optimal correction. There is evidence that hyaluronic acid fillers such as Juvéderm and Restylane actually help to stimulate the production of new collagen by your own body so that longer duration of improvement may be seen. Also depending on various factors of your health, weight and body chemistry as well as the volume injected and the skill of the injector duration of correction may be shorter (or even longer) than two years.
What does the XC after Juvéderm Voluma XC mean?
XC means there is a small amount of lidocaine mixed with the Juvéderm which helps to numb the area during the treatment process.
Are the Voluma injections painful?
There is typically minimal discomfort during the treatment process. Topical numbing cream may be applied before treatment to reduce discomfort – especially for sensitive areas such as fine lines around the mouth. Numbing shots are normally not needed so that you do not have the long-lasting dental type numbing effects after you leave the office.
How young can you be treated?
While we do not want to treat with fillers before they are really needed, the experience in Europe, Canada and elsewhere suggests that a relatively small amount of Juvéderm Voluma can produce a very pretty soft, natural look in younger patients who are showing early signs of aging or who have a tired look. Its actual FDA approval is for use over age 21.
Does it matter if I am 30, 40, 50 or older for treating or for the results I will see?
Yes it does. While you may benefit at any of these ages – as well as much older, there are potential differences. Younger women (and men) who do not have much skin laxity and who have primarily some early fat volume loss in their cheeks may see a relatively dramatic restoration of their youthful appearance before the fat loss occurred. Also the amount of volume of Juvéderm Voluma XC needed to produce these results may be relatively small – thus giving a really nice benefit for a relatively low cost. As time passes and more aging changes have occurred (especially for smokers or people who have severe sun damage or who may have had significant weight loss and other lifestyle and medical factors) the amount of Juvéderm Voluma XC required to produce optimal correction or restoration does increase and the costs also increase accordingly.
The results still will usually be impressive but may need to be combined with some other non-surgical procedures to create the most pleasing overall anti-aging effects. However for people who have been receiving other fillers in the past, they may find improved results for less total volume of filler material and also with greater longevity. Practically speaking there really are not so much absolute age limits for you to have very nice results with Juvéderm Voluma XC. Some people are biologically much younger (or older) looking than their chronological age and one of the really critical factors is for you to consult with an expert injector who has a good eye for the artistic natural look and also has the technical skills and who is an experienced injector that understands Juvederm Voluma well. You really also would like to choose someone for your consultation who will listen to what your goals are and also your lifestyle factors and budget and try to give you an individualized and practical treatment plan designed just for you.
Can all skin types be treated?
Yes. Juvéderm Voluma is excellent for all skin types. People with darker skin of color usually do not wrinkle as much as lighter skin tones, but everyone experiences age-related volume loss in their cheeks. Darker ethnic skin patients tend to be more likely to develop dull, ashy or unevenly pigmented skin which can be improved with skin brighteners (SkinMedica Lytera Cream is a product from the creators of Juvederm Voluma which often works well for these darker skin patients also still experience sagging of the apex of the cheek with aging and this may appear at a relatively young age. The cheek apex is what gives a youthful look to the face so restoring this can provide a very pleasing, natural and youthful look and typically this does not require much of the Juvederm Voluma due to its unique filling and lifting ability problems).
Can men be treated with Voluma?
Yes, however the technique is somewhat different especially for cheeks because what is optimal to create a younger male appearance differs from that needed for females.
How long does treatment take?
That depends on the extent of the areas being treated, the volume of Juvederm Voluma being used and also the complexity of the treatment. Simple injections might take only 15 or 20 minutes, but treatment can require considerably more time depending on what is being treated. For example full face sculpting may require using more of an artist’s pallet approach with the use of both needles and the European micro cannula technique and we sometimes need to blend the Voluma with additional lidocaine to customize treatment for non-cheek areas. We may also use other forms of Juvederm such as Juvederm Ultra or Ultra Plus to treat residual smile lines or furrows (note that by lifting the cheek, Voluma often reduces or eliminates the need to treat nasolabial or nose-to-lip folds and smile lines). So the more complete and creative the treatment the more treatment time is required. The artistry is a vital part of truly rejuvenating the whole face and that adds another dimension beyond just the technical skills for injecting. Juvéderm Voluma is a dramatic addition to our artist’s pallet and as cosmetic artists we want to create the most natural beautiful appearance we can.
Can you combine Juvéderm Voluma XC with other facial anti- aging treatments?
Yes that is a great question. Often for optimal restoration of a youthful appearance more than one modality is needed. So Juvéderm Voluma restores volume and can lift sagging skin. If the outside of the skin has chronic sun damage and is thinning from lost collagen then a fractional laser or IPL treatment may be useful. Likewise, if spider veins dominate the landscape of your face, a blood vessel laser treatment may be helpful. Lines of facial expression often will respond well to Botox and a particularly good combination is Botox and Juvederm Voluma. Eyes are important as well and sometimes a bit of a ‘lift’ can be achieve by either Botox or Juvéderm. Eyelashes can be made longer, thicker and darker using Latisse. Topical skin products such as Retin A and antioxidants help to repair old damage as well as to protect your investment in some of these treatments. Allergan, the creator of Juvederm and Botox, also makes SkinMedica which is one of the leading science-based lines of anti-aging skin care products and their new Lytera cream helps improve uneven skin pigment. Many combinations are possible and should be customized to your skin, your lifestyle and budget.
Does it matter when you combine these treatments?
Yes. It is thought that some combination of treatments – especially when treating the same anatomic area – may in most cases be better performed at different times. This is especially true for some of the laser and light treatments or peels which can create swelling and possibly interface with the use of Botox at the same time. You should discuss with your physician because many treatments can be combined at the same treatment visit. Botox and Juvederm for example are often a great combination at the same time, but there also are exceptions to this as well.
When can I return to work and resume my social life?
Juvederm Voluma XC results are immediate and very natural looking, so typically you may return to work or social activities immediately. However, sometimes transient side effects occur – in particular bruising – and mild swelling may develop by the next day, so you do need to consider this in your planning. This is especially true if you have never been treated before or if you are taking things which might increase your risk or the severity of bruising like baby aspirin, blood thinners, fish oil, etc. So discuss this with your physician.
What are the common side effects of Juvederm Voluma XC?
Typically you might experience temporary bruising, tenderness, swelling, pain during injection or some redness or itching. Lumps and bumps are possible but usually are easily massaged out either at the time of treatment or a few days later. Depending on your facial anatomy sometimes asymmetry or unevenness from side-to- side might be experienced which can usually be easily corrected, however people commonly have some degree of natural asymmetry which may not be able to be perfectly matched. Most of these are very transient but may in some cases last for a few weeks. Consult with your doctor about your particular situation.
What can be done to prevent bruising?
Bruising is one of the most common side effects. Tiny bruises at the sites of needle entry may be very inconspicuous and easily covered, but larger or darker bruising that is visible and lasts for days or rarely longer can be rather unsightly. Sometimes (if medically safe) people taking daily aspirin or other blood thinners may temporarily discontinue treatment (always consult your prescribing physician first if you are taking these for medical conditions). Fish oil supplements may be discontinued for a week before treatment and then resumed. If your injector has a pulsed dye laser or certain types of IPL you may be able to return within 24-48 hours for a quick zap. These typically are very safe and speed the resolution of the bruising.
What if I don’t like the results – can Juvederm Voluma XC be removed?
Yes all hyaluronic acid fillers can be ‘removed’ using a synthetic form of an enzyme that occurs naturally in our bodies called hyaluronidase. Usually the filler can be removed in hours to a few days after injecting the appropriate amount of hyaluronidase. All Juvederm products including Voluma may be treated this way.
How often can I be injected? A better question is when do you need to be re-injected?
Since Juvederm Voluma is very long-lasting filler you typically would not need to be treated again for a long time…up to two years or more. However re-injection may be needed a few weeks after your initial injection if you need more volume or more lift. Often it is better to be conservative and touch-up if needed. I personally see so many people who have been over-injected or overfilled and this is especially true I find for cheeks and lips. While certain people in the entertainment business for example may with intentionally desire a bit more exaggerated look, I have a very strong commitment to creating a very natural, soft, rested appearance. It is nearly always better in my opinion to remain natural and understated – especially if you have never been treated before. Juvéderm Voluma does not require as much volume as other hyaluronic acid fillers to create the effect you want and so care must be taken for injectors who are not as experienced with Voluma to not overdo your treatment. Allergan, the creator of Juvederm Voluma XC has made exceptional efforts to provide proper training for Voluma and it really is very important that you have an experienced injector.
I also suggest you ask to view photos of the actual injector who will be treating you so you can see their results and judge for yourself if that look ‘fits’ you. Some of the best Juvederm Voluma injectors in the world will tell you that optimal correction will give you the ‘best’ overall look and the longest duration. To achieve this you may need to return for some touch-up or additional amount of Voluma to achieve this result…and that doing this typically then leads to the longest correction before you need injected again. So your goal should be to ‘get it right’ and then to not need to be injected again until the results begin to fade.
How much does Juvéderm Voluma cost?
That is a great question but it has a very individualized answer. Because Juvéderm Voluma is such a ground-breaking filler it really is quite a bit different than you might be used to from your experience with previous fillers. With Voluma we are now not only restoring volume but also providing lift and some indirect tightening. So if you have been injected with fillers in the past you need to think more about ‘full face rejuvenation’ – and think less about ‘filling lines and wrinkles’. Much of the filling of lines/wrinkles/ folds of the past will either not be needed – or the amount of filler needed will be significantly reduced.