Voluma (Juvederm® Voluma)

Introduction
Juvederm® Voluma is a hyaluronic acid soft tissue filler which received FDA approval in October of 2013 for deep (subcutaneous or supraperiosteal) injection for cheek augmentation to correct age-related volume deficit in the midface of adults over the age of 21. Juvederm® Voluma is processed by a patented Vycross gel technology providing unique characteristics of long duration in deep soft tissues and stability in volume correction which translates into a desirable lifting effect.

Dr. Liu is a recognized expert in Voluma treatment techniques, training other physicians through the Allergan Facial Aesthetic Training Programs and P.A.L.E.T.T.E. Live Injection Training Programs for advanced techniques.

What can Voluma improve?
Voluma's versatility can treat a broad range of age-related facial changes from lifting sagging facial structures, restoring volume to eliminate shadows, removing wrinkles, and restoring proportional balance through structural contouring.

How do I know my appearance will not look artificial or unlike me?
Results of cosmetic injectable procedures are influenced by:

(1) the properties of the material

(2) the application of the material by your provider

(3) the vision of your provider

Dr. Liu's philosophy of facial rejuvenation is summarized in the 4 C's below:

(1) Communication-listening to patients is the critical first step in developing a treatment plan and communication of the plan is equally important. Verbalization and demonstration of the shared goals leads to positive outcomes.

(2) Conservative-acknowledgement of individuality and application of a conservative approach to stay within the framework of each patient's unique facial structures leads to undetectable, but noticeable improvement.

(3) Consistency-delivery of consistent results over time provides patients continuity of their appearance and imperceptibility of their aesthetic treatments.

(4) Customize-meticulous analysis of each patient's skin, soft tissues, and bony structures to formulate an individualized plan delivers optimal results. Each treatment session is tailored to deliver the best treatment at that moment with consideration to long-term goals.

Dr. Liu categorizes Voluma treatment goals into one or a combination of the 3 R's below:

1) Retain- Voluma can retain the proportions of a youthful face at the earliest appearance of shadows, sagging, and/or lines.

2) Restore-Voluma can restore the proportions of a youthful face after shadows, sagging, and lines have become clearly visible.

3) Reshape-Voluma can reshape facial structures to achieve symmetry and proportion in appropriate cases.

Patients describe Voluma treatments as "dramatically subtle"

EXAMPLES OF VOLUMA RETAINS

Left Photo-very early volume loss creating minor shadows, sag, and lines. Mid-face beginning to lose contour.     Right Photo-Juvederm® Voluma injected to restore lifted contours of a youthful face.

Left Photo-Pt desire bit more fullness to her lips with a natural look and feel; minor sagging of face.     Right Photo-Very small amounts of Juvederm Voluma and Juvederm Ultra to cheek, smile lines, and marionette lines. Lip fullness improved using single syringe of Juvederm Volbella.

Left Photo-"eyebag" since childhood. Early volume loss creating an indent in the mid cheek and "weight" against the nasolabial fold (smile line).     Right Photo-Juvederm® Voluma injected to soften "eyebag" and retain cheek lift. .

EXAMPLES OF VOLUMA RESTORES

Left Photo-Patient feels her eyes look tired and her mouth unhappy.     Right Photo-Juvederm® Voluma injected to lift sagging tissue and soften shadows and wrinkles. The "smile lines" (nasolabial folds) softened without injection of Voluma directly there.

Before-Corner of mouth and lower jaw sagging and wrinkled     After-Juvederm® Voluma injected to subcutaneous & supraperiostial layers to restore lift and smoothness to corner of mouth and chin.

Left Photo-Patient feels cheeks are sagging, eyebags are forming, and mouth looks unhappy.       Right Photo-Juvederm® Voluma injected to soften eyebags, lift cheek, and lift corner of mouth.

*actual patient case of Dr. Liu©

EXAMPLES OF VOLUMA LIFTING

Left Photo-Patient dislikes deep line coming off corner of her mouth.     Right Photo-Juvederm® Voluma injected achieving significant lift to the neck, jaw, and corner of mouth.

Is Voluma safe?
Voluma is derived from hyaluronic acid, a naturally occurring water molecule which is identical across animal species. The incidence of allergic reactions or permanent side effects is extremely rare. Voluma has been safely and effectively used worldwide for approximately 10 years. Most important, patients can feel reassured that if an unusual reaction or undesirable results should occur, Voluma can be painlessly and rapidly removed by dissolving the material with a fluid-based enzyme, which is very rarely done.

How long does it last and how do I maintain results long-term?
The clinical studies of Voluma noted a high percentage of treatment results maintained at one year and upwards to two years. Two maintenance schedules have evolved with Dr. Liu's patients. After the initial treatment, one cohort of patients return approximately every 12-24 months for repeat treatment. A second cohort of patients prefers to returning every 6-9 months for a partial booster treatment. This second cohort has been patient driven due to their desire to have consistent correction of the smoothness, lift, and wrinkle correction they have experienced from Voluma treatments.

Is the procedure painful?
The procedure is very well tolerated with use of prescription strength topical anesthetic cream and/or ice. Patients report none to minor discomfort and/or pressure.

Is there downtime?
Voluma frequently has no downtime or very minimal downtime due to its unique property of stability in volume correction (swelling is minor or nonexistent in almost all cases) and use of a combination of blunt-tipped cannulas and a variety of needles (bruising has been infrequent)