Juvederm Voluma- the Newest FDA Approved Cheek Filler is Here Soon!
Our European and Canadian colleagues have known a secret for cheek augmentation for the last several years that will soon hit our county with the newest FDA approved filler Voluma from Allergan. I just returned from Toronto as a member of the Allergan Voluma Advisory board with about 50 other multispecialists from around the United States.
So what is all the buzz? We have seen a filler revolution over the past decade with FDA Approval of hyaluronic acid fillers Restylane, Perlane, Juvederm Ultra, Juvederm Ultra Plus and most recently Belotero from Merz. Each of these fillers is successful in their own right and has various applications. The one thing that they have in common is that they are dermal fillers. The big thing about Voluma is that it is not a dermal filler, but rather is intended for subdermal use from the periosteum on up. While the other hyaluronic acid fillers have FDA approval for treating winkles, Voluma is not for wrinkles, but rather for Volumizing…..hence the name Voluma.
Another big difference with Voluma is the cross linking. All fillers have a process called cross linking that stabilizes the molecules, provides thickness and prevents the body from breaking down the filler. This is why hyaluronic fillers work so well and last so long. Voluma has a proprietary cross linking from Allergan known as “Vycross” cross linking. Vycross technology provides an increased “G Prime” which is a measure of thickness and moldability of the filler. Fillers with a high G Prime provide more lift and usually last longer. A low G Prime is like water, a high G Prime is like Jell-O. It is stiffer and holds things up better. Also, Vycross makes the filler less hydrophilic which means it draws in less water from the surrounding tissues and produces less swelling or unwanted bloating of the area. Allergan has data of Voluma lasting 2 years in the cheeks. A syringe of Voluma has 20 mg/ml of hyaluronic acid and 0.3% lidocaine to help numb the area when injecting and increase flow properties.
Again, this is the first FDA approved filler with an indication for cheek augmentation. Voluma is not for the dermis and not for wrinkles, folds and lips.
In Toronto we all had the ability to study this filler including live Injections. The thing that struck me most was that a little bit of Voluma goes a long way. The other useful and interesting thing about the live injections was the fact that the volumized cheeks improved the tear troughs and nasolabial folds due to the lifting properties. Being a long time user of cheek implants, I have seen the phenomenon many times. All fillers do this to a certain extent but the before and after pictures of Voluma were impressive.
The injection techniques are slightly different for Voluma and it is somewhat more resistant to hyaluronidase if a patient desires it to be dissolved. It would require more hyaluronidase due to the Vycross cross linking. It is important not to inject large doses in a single area but as most experienced injectors already know, to spread it around in multiple tissue planes.
Since Voluma is injected deep into the face, it is imperative to seek very experienced injectors and doctors intimately familiar with the deep facial anatomy to avoid complications.
I am excited and honored to be included in the very first wave of surgeons who will have access to Voluma in the very near future. Technology is exciting and the Canadian experience has been excellent.
For more information about injectable fillers or cosmetic facial surgery by Dr. Joe Niamtu visit www.lovethatface.com.
Joe Niamtu, III DMD
Cosmetic Facial Surgery