Nodules after Voluma

Dr. Alan Durkin describes the best kinds of laser skin treatments.

Nodules after Voluma

Observations from the field about Juvederm Voluma

Juvederm Voluma® has been a mainstay of nonsurgical facial rejuvenation since its debut in 2014.  Based on their proprietary Vycross® technology, Juvederm Voluma® was engineered specifically for midfacial volumization and rejuvenation. FDA approved for use in the midface, Voluma® has enjoyed remarkable success in the American facial rejuvenation market.

Juvederm Voluma® is a reversible, hyaluronic acid filler that is widely used as injectable therapy to the human midface.  Allergan claims that Voluma® generates its lift via asymmetric molecular sizes, in conjunction with their Vycross linking technology.  Their FDA study did register a consistent one point or greater midface improvement over 2 years following initial corrective therapy, and a 30-day interval touch up.  Subjects in this pivotal study received, on average, 6.65 tubes of Voluma®.  That’s right….7 tubes of Juvederm Voluma®.

To say the least, that’s a large amount of filler to place in just the midface.  Because of the degree of volume required for correction, Ocean Drive Plastic Surgery® elected early on not to promote this product.  Not only did Voluma® require the greatest cost, Dr. Durkin determined after reviewing the available literature that its duration was highly variable, anywhere from 4 months to 15 months.  On our own experience, we did not see a two year duration in our patients, regardless of volume used.

Overall, we feel that Voluma® is a good product, but we have yet to see its vaunted two year duration in our patient population.  Recently, there have been significant concerns about long term nodule development occurring in conjunction with Juvederm Voluma®.  Dr. Durkin has been told by many clinical sources that there is a growing concern that Voluma® may be resulting in long term subcutaneous nodule formation.  Therapy for these nodules has ranged from watchful waiting to surgical removal, depending on each case.

For Ocean Drive patients, please rest assured that we have never used in any substantive volume this specific filler.  When introduced, Dr. Durkin was one of the few physicians that did not adopt Juvederm Voluma®.  Due to its higher price point, variable length of action/duration, and its excessive volume requirement, we did not promote the use of this product and have very few Voluma patients nationwide.  We prefer to use biologics such as autologous human fat (aka structural fat grafting), or Renuva®, or biostimulatory agents, like Radiesse® for the midface.

Human fat is just that, your fat!!  We remove the fat via liposuction with platelet-rich plasma, centrifuge and purify the fat, and inject it back into the human face for long term correction.  Renuva® is a first in class biostimulatory product that allows for the creation of human fat cells.  Used primarily for correction of liposuction “dents”, Renuva® also plays a significant role in nonsurgical gluteal augmentation.  Radiesse Plus® is a calcium hydroxyapatite filler that is FDA approved for use in the human face.  Via its proprietary calcium microspheres, Radiesse Plus® allows for bioinduction of new Type I Collagen.  None of these products have been associated with long term nodular effects.

Dr. Durkin

serving patients in Vero Beach, Sebastian, Melbourne,  West Palm Beach, Fort Lauderdale, Orlando,  Miami, FL