”I’m talking a little bit about facial fillers today and more specifically about the new facial filler, it’s the HA or hyaluronic acid filler known as Voluma, Juvederm’s Voluma made by the Allergen Corporation. Voluma was released in late 2013, there was an investigator or a key opinion leader meeting in Southern California where everyone gathered together and a presentation was made by a South American surgeon who described his way of doing mid-face volume enhancement. I’m not sure I completely agree with the strategy that he employs, what I do agree with is that there are mid-face volume changes that occur with all of us as we eclipse 40.

Namely, the distribution of fat sinking down creating a nasolabial fold and then a relative hollow under the eye that looks something in the shape of the V, which we call a negative mid-facial vector. By using Voluma or any of the HA or other types of fillers, we’re able to restore the contour to the eyelid region, the eyelid rim region and actually elevate the cheek slightly.

Now this is not a substitute for facelift, and I’ve seen way too many people out in society walking around with really over blown-up cheeks and faces and it doesn’t really make you look more youthful to have a chubby puffy, looking face.

There are two components to the aging process, one is loss of volume and the distribution of that volume and the other is the envelope that the volume underlies. That envelop is significantly sagging or jowling, it is probably better to do some combination of this surgical intervention or a skin lifting procedure even if its non-surgical like the Ultherapy device along with the volume enhancement that really helps to restore the contour.

The goal with all of these products should be to restore a natural youthful look. Not to make one look puffy or blown-up like a balloon. Not to make one look pulled or overly tight, that’s not really what we’re trying to achieve. We’re trying to achieve a natural restoration of facial contour, a youthful more energetic look when we’re using these products.

Strategically when we use these products, there are not many downsides to the use of them. People ask very commonly about the side effects. The most common ones of course when we’re doing any type of injections are bruising, and bruising can happen anytime when needle passes even the smallest little blood vessel, if that blood vessels leaks even slightly, there’ll be a small bruise. The idea in preventing bruising is to make sure that we avoid the use of non-steroidal anti-inflammatories like Advil, Aleve, Motrin and of course aspirin that really prevents the use, the platelets from plugging the little vessel up if that vessel was to be injured.

Side effects like long term infection or granulomas while they have been reported with the HA fillers, I’, unaware of any reports specifically with Voluma to date, but those would be potential, although quiet rare side effects and then very careful technique I’ve got a series of integrate injection techniques that I’ve described both in the medical literature and lectures that I have given that I think helps push the vessels out of the way as the product is injected.

So the incidents of bruising is much reduced when we use this techniques. We avoid aspirin and a little bit of icing is not a bad idea either prior to the treatment which constricts the small blood vessels a little bit and again helps us to avoid them slightly. And again, that’s why you want to go to a licensed expert practitioner when seeking treatments with products like injectable fillers that are really implantable devices. There’s a technique, a skill and a science to using these properly that get patients the best results for the long term.

As always it’s my pleasure to answer to answer your questions. You can find out more information at MaasClinic.com. You’re certainly welcome to either send videos, photos or just questions to our video blog at DrMaas.com and I’m happy to answer those questions. As always Corey S. Maas MDTM on Looking Your Best.”

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