Thank you for your question.
You submitted two photos and in your question, you described a situation where you describe
your facial structure as being a little bit odd and referring to some flatness in areas
around your cheek.
And you’re asking about the benefit of potential fillers and specifically, Voluma.
I certainly can give you some guidance with this question.
This is a type of question that comes up in my practice every day.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And augmenting the cheekbones to help particularly enhance the whole shape of the face and particularly,
the area around the eyes is a very popular procedure in our practice.
And I would also like to address the question about the approach and you asked a specific
name brand called Juvederm Voluma.
And part of the reason why you are probably thinking about Juvederm Voluma is that the
company Allergan got the FDA approval for mid-facial augmentation with this filler.
I can tell you a little bit more of about how we use it because one thing that I always
try to emphasize in educating people about injectable fillers is that companies promote
the use of their product and the product almost becomes a concept that people feel is equivalent
between practitioners.
And I try to differentiate for my patients and for people who are interested in learning
that the product is still a tool for a practitioner to accomplish a specific outcome.
Very often, just like there’s a positive association with the product, sometimes there’s
a negative association.
People will say things like “I tried Voluma but it didn’t work for me.”
Well, I always tell them yes, that might be possible but it could also be the way the
Voluma was placed or the amount that was placed can also be an issue that led to an unsatisfactory
result.
So in our practice, we do something called structural volumizing and I think this is
very much in line with the concerns you have because what you are describing is essentially
a genetic volume deficiency of an area around the eye and around the cheekbone.
So what differentiates structural volumizing from traditional filling is that structural
volumizing, we’re placing the filler at the bone level and it’s done at, what I
feel, a very elegant approach using different methods that minimize bruising, minimize swelling
and minimize trauma.
And generally speaking, many doctors who use injectable fillers place fillers using a needle
and directly into a soft tissue compartment.
Certainly, that’s the most popular approach but what I find is often the case is that,
either too small a volume is used so that you don’t get the best volume correction
or the other side which people always notice is too much volume is placed and the soft
tissue becomes too rounded or it becomes too heavy.
With structural volumizing, it’s being placed on the bone structure and we are able to get
this beautiful cheekbone definition.
This is not promoting the procedure itself but it’s giving the guidance as to the differentiation
on how a filler such as Voluma can be used in different areas.
One of the advantages I feel specifically about Juvederm Voluma since you asked about
it is that the material is actually designed in a way that gives it more body, more viscosity
which gives it more strength when you place it and it tends to absorb less water as other
hyaluronic acid fillers do.
When there is less water absorbed, there’s actually less swelling.
So that itself is a great advantage as a product.
But remember, you want to differentiate the product from the practitioner.
So I would recommend you find and look for a physician that you feel comfortable with
trying this product or other products depending on what your physician feels most comfortable
with.
Learn about your options.
Think about what kind of outcome would be satisfactory to you and then take the plunge.
Try to see if you like the results.
So I hope that was helpful, I wish you the best of luck and thank you for your question.