Dermatologist Dr. Herzog educates readers on voluma: how it stacks up against other fillers and how to know if a voluma deal is really a deal.
Dr. Jo Herzog
Several people have asked me about something that they have seen on TV this week, so I will answer everyone at once. I have not seen the advertisements or the shows, but apparently there has been talk of a new product called Voluma. I am familiar with it, as it has been talked about in the dermatology community and has been used for quite some time in other parts of the world.
Voluma is a new filler that we can add to our toolbox of other fillers. It was recently FDA approved in the USA for filling the cheek area. This is the first hyaluronic acid (HA) filler that has been given this specific indication (other HA fillers are Juvederm, Restylane, Perlane, Belotero etc.). Certain fillers have been approved for specific indications, but an experienced injector that has used them for a while can use different fillers in many different ways to give you the best cosmetic outcome possible.
Allergan, the makers of Voluma, are marketing this as a new filler that has a lot of cross linking and will give you lots of “lift” that will last a long time compared to other HA fillers. Advertisers are stating that it lasts 18-24 months, and some are stressing the fact that this is fully reversible if you don’t like it. So, what is it giving us that is new, and how is it better or not better than what is already in our toolbox? (Remember that we are talking about the mid-face – not lips, under eyes, fine lines etc…) Let’s take a look at the claims and how Voluma stacks up against its competition.
More lift– Perlane is a similar product (highly cross linked HA) that is made by a different company. It probably has similar lift, but only a study where we inject a different filler in each side of the face will tell us for sure. Radiesse is a thicker product of a different type. It gives a wonderful amount of lift that will be hard for a HA filler to beat, but we will see only after experiencing results from both. Sculptra gives lift in a totally different way but gives a wonderful amount of lift to the face when used properly. Juverderm, Belotero and Restylane will not compare to any of these in the ability to “lift”.
Lasting power– Juvederm, Belotero and Restylane will not last as long as Voluma is said to last. Likewise, Perlane probably will not last that long if Voluma indeed lasts as longs as Allergan claims that it does. Radiesse might last as long. Sculptra certainly should last as long, perhaps longer.
It is important to note that Voluma might LAST IN SKIN ON BIOPSY for 18 months to 2 years. What we want to see is how long acceptable results that make our patients happy will last. Hopefully two years.
Reversibility-We have other HA fillers in our toolbox, all of which can be reversed if you don’t like your results. Likewise, Voluma can be reversed too. That being said, you must look at what that will do for you. Hopefully, you will use an injector that will do the job that will make you happy so that reversing your treatment will not be an issue. In all the years that I have done fillers, I have done one reversal on my own patient (who thought that fillers gave her a headache). I have done a few reversals for patients of other doctors. Without going into further detail, let me emphasize one thing. For your own safety and for your overall satisfaction, if you are going to have anything injected into your face, choose a board certified dermatologist or plastic surgeon. If you do this, reversibility need not be a key factor on your list when choosing a filler.
Cost– Is money an option? If it is, you need to know several things. 1) How much of a material you will need and how much each syringe, cc or vial costs. 2) How much volume each filler will add and for how long. 3) How much your treatment will cost and how often it will need to be repeated. If the procedure costs more than a facelift and lasts two years, is it worth to you? Will you get a couple of years out of this for a reasonable cost with no anesthesia and no hospital? I am not sure of cost yet; I will update you when I have more information.
Down time- Expect little or no down time with this procedure. If anything, minor bruising might occur.
Visits-In general, most of the fillers have instant results and can be injected in one visit. Some doctors prefer to break visits up and do a gradual job. I think Voluma can be a one visit job unless you choose to break it up into separate visits. Scultpra usually takes a few visits to get the best results.
What the ads may not have discussed is building collagen. Of all of the fillers discussed above, only Radiesse and Sculptra have been shown to build a significant amount of collagen . This is important, because as we use these we might need to use less over time and use less often if building collagen.
So, what about this new product, Voluma? I think that this will be one more filler that will be used to perform functions similar to that of Perlane, Radiesse and Sculptra. It remains to be seen whether it has more “lift ” than other fillers and how long results last compared to other fillers. Each patient’s needs will determine what filler might be best for her. Those who need large amounts of volume will still benefit more from a filler like Sculptra. Those who have a wedding to go to next week will want faster results which comes from another filler.
It remains to be seen how much longer this lasts than other fillers and how much the cost difference will be, as I do not yet know the price per CC syringe compared to others. If Voluma does indeed last two years and costs the same as that of a shorter lasting filler, it will have a good chance of replacing those fillers on the market for mid-facial rejuvenation. I do think that it will do a good job of volumizing the cheeks.
What is most important? Chose an injector that has experience and that you trust. Make sure that they use multiple products. Injectors that use only one or two products don’t have a full toolbox. Do they use HA’s and Radiesse and Sculptra? Don’t go in and ask for what you saw in a magazine or on TV. Tell them what bothers you, ask them the best way to fix it, and trust their opinion. They know what works well for each specific problem and what they feel most comfortable using. If ever you are uncomfortable, walk out.
Hope this was helpful. I will keep you updated as we use and try new materials as well as when we find out the costs.