This Article Has Been Medically Approved By

Dr. George H. Sanders

The Juvederm product line may have just gotten better!

Voluma is here!!!

For those of you who are wondering what I am talking about, Juvederm is a facial filler that is used to plump up wrinkles and folds of the face. It’s made of hyaluronic acid, one of the major components of skin. If you think of skin as pineapple jello, the chunks of pineapple represent the collagen and the jello represents the hyaluronic acid. In the past doctors would inject collagen, but abandoned it when longer-lasting hyaluronic acid fillers such as Juvederm and Restylane were introduced that have virtually no associated allergic reactions. Until now Juvederm was limited to filling folds, wrinkles, grooves, and plumping lips. A longer lasting form called Juvederm Ultra was introduced a few years ago that lasts up 1½ years, and Xylocaine was added to reduce the pain of injection, giving us Juvederm Ultra XC. Most recently a new form of Juvederm was introduced called Juvederm Voluma HC that can now be used to fill the cheeks.

As people age, two things tend to happen: 

  • Cheek fat droops into the jowl area


  •  People lose fat in their cheeks 
  • Drooping fat can only be lifted via a surgical cheeklift or facelift.  This takes the drooping fat and adds it back to the cheeks, correcting the problems of lost fat and drooping fat at the same time. If drooping fat is a major problem a lift needs to be done. Some patients want to do anything to avoid a lift, so they favor addition of volume to the cheek area that will tend to camouflage the drooping fat. If there is loose skin in addition to the drooping fat, however, it’s very hard to hide this with addition of volume to the cheeks alone. A lift is almost always required for an acceptable result.
  • Assuming the patient has opted for replacement of lost cheek volume, up until now, replacement of the lost fat has required a cheek implant or fat injection. Cheek implant surgery involves a sedation anesthetic, an incision inside the mouth for insertion of the implant, and a week of recovery involving some mild swelling. The advantage to a cheek implant, however, is that it’s a permanent solution to the problem of lost cheek fat.
  • Fat injection is another solution, but one that usually needs to be touched up every year or so. Fat is removed from the thighs or abdomen and injected into the cheeks under local anesthesia. There’s always some bruising and swelling at the site of injection as well as the donor site that may last two weeks or so, but it can be comouflaged with makeup. Fat injection, however, is somewhat unpredictable when it comes to knowing how long and what percentage of the fat will last. 
  • If you don’t mind the need for periodic injections, you may also want to consider Juvederm Voluma XC , known as Voluma. It’s injected into the cheeks without the need for an allergy test. Its advantages over fat injection include the facts that it comes out of a bottle instead of requiring a donor site, reproducibly lasts 1½ to 2 years, and patients can usually return to normal activities within 24 hours. “Side effects such as tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching are moderate and generally last 2 to 4 weeks,” according to the manufacturer.

                                               (Results courtesy of

If you are looking for a non-surgical solution to flattened cheeks that may last up to two years, consider Voluma. Many of our patients who have used Juvederm to fill wrinkles, folds,  and  lips are giving it a go. The results are quite encouraging!

Please feel free to comment.

George Sanders, M.D.