By Ina Paiva Cordle
Dermatologists and plastic surgeons have a new, nonsurgical weapon to add to their anti-aging arsenal.
Juvederm Voluma XC was approved by the U.S. Food and Drug Administration in December as the first injectable filler to instantly add volume to the cheek area. Similar to other fillers like Restylane, Juvéderm, and Perlane, Voluma is made of hyaluronic acid, a natural substance found in the skin. But Voluma offers special benefits, doctors say.
“It’s unlike anything else available,” said Dr. Kenneth Beer, a dermatologist with offices in West Palm Beach and Jupiter. “You can lift the face, you can sculpt the face, you can reverse facial aging, and we can now do it in a way that lasts for at least 18 months, and in some cases up to 24.”
Both Beer and Dr. Leslie Baumann, a Miami-based dermatologist, were among the small number of doctors nationwide who took part in research trials for the filler. The trials started about four years ago and ended about two years ago. They were conducted using an average of about five syringes per patient.
“It’s not just anti-aging — it also changes the contours of your face,” said Baumann, who writes a column for the Miami Herald. She particularly likes Voluma for its longer-lasting quality as well as for how it allows her to better mold the face.
“It also fills in space better, so a little goes a long way, and it has more lift, so it will pop up the skin more than the same volume of the other fillers,” said Baumann, who has injected more than 300 patients with Voluma, using an average of two or three syringes. “And it feels very soft and natural in the skin. You don’t feel it after it settles.”
Voluma also can be less painful than other fillers because it is injected deeper into the skin, where there are fewer nerves, Beer said. For the same reason, it may be less prone to cause bruising, since it is injected under blood vessels, he said.
“As we age, the ligaments and tendons that hold the fat pads in the skin expand, so everything goes south, and we get jowls and sagging,” said Beer, who has injected more than 100 patients, using an average of two to four syringes. “And it can literally lift the face up. It’s a facelift that is anatomically correct, so instead of looking like you are in a wind tunnel, you look like you have the volume back when you were young.”
However, the proverbial fountain of youth does not run cheap. Doctors generally charge up to $1,000 per syringe of Voluma and can use from two to as many as six syringes per person. Yet Baumann points out that Voluma may be more cost-effective than Restylane or Juvéderm — which generally costs $600 to $700 a syringe since it can last twice as long.
“I see it as a great option for people, like men, who can’t afford to be bruised every nine months,” Baumann said. “With this, you can do it on a Thursday and take Friday off and be back at work on Monday, and no one will know you did anything.”
Yet doctors caution that injecting Voluma requires special training and an understanding of such aesthetics as facial harmony and bone structure. So patients should see a doctor who has experience with Voluma, they say. “If a doctor doesn’t have an artistic eye, you can look really fake with it,” Baumann said.
A natural result was key for Nathaniel O. Wilkins, a 59-year-old fitness professional who was part of Baumann’s original Voluma research group and recently returned to her for another dose.
“I represent the face of health and wellness, so it’s important for my body to look good, but I think we’re also responsible for our face and what we look like,” said Wilkins, who lives in Aventura. “So this is just a way to continue to project the best image for myself and the profession.”
Indeed, for men as well as for women, the lift effect can be significant, Baumann said.
“Men get that separated look in their mid-face — you see it in the mid-cheek,” Baumann said. “Just putting a little bit of filler takes decades off, and it is undetectable.”
Besides the cheek, both Beer and Miami dermatologist Dr. Alicia Barba, of Barba Dermatology, said they have also injected Voluma in other areas such as the hollows of the temples, the chin, and the jawline.
And they have also used Voluma in conjunction with other fillers like Restylane to fill in the nasolabial folds — the creases that run from the sides of the nose to the corners of the mouth.
“It is a wonderful product. When injecting it is very smooth, it’s very moldable, malleable. If I want to inject a little, I can press down and get it flat, to do what I want it to do,” said Barba, who was part of a group of doctors given Voluma in October, before it came out on the market. “And from a safety point of view, if the patient didn’t like it, it can actually be resolved, whereas another product like Radiesse can’t be.”
She said hyaluronidase can be used to resolve hyaluronic acid fillers in 24 to 48 hours. But she tells patients to wait a week or two to decide because they may have swelling — and said most patients end up loving the result.
Overall, Barba, who has injected more than 40 patients using an average of two syringes per patient, takes a conservative approach.
“We finally have something indicated for cheeks,” she said. “Whether it’s going to be better than anything else we have on the market remains to be seen,” she said. “I’m super excited to have it, but it also makes me a little nervous. Now anybody can inject it, and it doesn’t mean everybody has a great sense of aesthetics,” so she, too, advises consumers to use an experienced doctor. “The best result is when you can’t tell. . . .”
“It works against gravity by adding to the cheeks, because if you lift — if put your finger at your cheekbone below the outer eye and pull up, you can pull the jowls up, and that is kind of the theory,” she added. “If we can place volume there we can pull up from the bottom and create a better jawline. That is great — until they stop looking like themselves.
“How much we can inject upwards, without changing what the person was, is something that takes a skillful eye. It also takes a strong sense of knowing when to stop.”