
Aging changes the shape of your face.
When you’re young, the fat in your face is evenly distributed. Fat pockets plump up your forehead, temples, cheeks, and the areas around your eyes and mouth. You look BEAUTIFUL!
But invariably, aging happens and that fat loses volume and shifts downward. Features start to sink. You lose fat in the mid face, temples and in front of the ears. Next you lose fat around your mouth, chin and along your jawline. Your skin looks like it's sagging, but your face is actually losing volume – or deflating.
And it only gets worse.
Your skin starts to lose elasticity causing even more sagging. The tip of the nose dips down because it has lost soft tissue support. Your upper lip lengthens, moving down, and your nose (because it's attached - haha!) is forced to follow.

The yellow areas are fat pads in the face. The more you have, the younger you look. On the left is age 35; on the right is age 45.
Image courtesy of WomensHealthMag.com.
The bridge of your nose sinks creating a horizontal wrinkle across the width of the bridge. Meanwhile, (due to the sagging) the lower half of your face gains fat causing a baggy chin and jowly neck.

Are you crying yet? Sounds awful, doesn’t it?! Well, there’s more.
Over time, the bones in your face thin and recede. The eye sockets widen and lengthen, the brow bone recedes and the jawbone loses definition. This bone loss adds to the deflated look of aging because these bones create a "scaffolding" for your skin and facial tissue.

Previously, we thought that skin changes were the main cause of facial aging; so facial rejuvenation focused on skin tightening. As time passed, the industry found that even the best skin tightening treatments were unable to make patients look like they did when they were young. This led to the realization that underlying structure changes added to the changes in aging skin – and Voluma was born.
Juvederm Voluma XC is changing the way we treat aging skin.
As mentioned above, when fat and bone is lost on the cheekbones, skin sags creating smile lines. Voluma takes the place of the lost fat pads. It adds volume by creating a scaffolding for the skin. When we inject Voluma onto the cheekbones, we are able to eliminate most of the need for fillers in the smile lines. These are the same lines that can give that “overfilled” look. After cheek injection with Voluma, Juvederm Ultra Plus can be used to minimize any remaining nasolabial/smile lines.
By using Voluma, we are able to create a very natural appearance – one that is much closer to a younger version of you. And you won’t look like you had surgery.
How long has Voluma been around? How long does it last?
Voluma by Allergan has been used in Europe since 2005. It has been approved in 72 countries to restore volume to the cheeks. In contrast, most other fillers are FDA approved for injection into the nasolabial folds / smile lines. They are considered “wrinkle fillers” not volumizers. Voluma is also unique in that its results can last for up to 2 years.
What is Voluma made of?
Juvederm Voluma is a hyaluronic acid gel. Hyaluronic acid is a sugar found naturally in the skin. It absorbs water and acts as a cushioning agent.
Voluma is VERY different from other volumizing fillers in that it is the only one that is immediately reversible. Because it is made of hyaluronic acid, it can be quickly broken down with a shot of the enzyme, hyaluronidase.
How does it work?
When injected into the skin, the hyaluronic acid acts as a sponge and expands to fill wrinkles and support sunken areas. The injections also jumpstart collagen production which, over time, will add even more fullness to the areas that are injected.
The results are amazing!
- 6 months after treatment with Voluma, 90% of patients reported increased satisfaction with their facial appearance and perceived themselves as looking 5 years younger than they were.
- At the 2 year mark, 76% of patients were still satisfied with their results and thought they looked 3 years younger than their actual age.
- % worth it rating based on 179 reviews in the last 24 months.

This man had 2.6 ml (that's 3 syringes) of Voluma injected into his cheeks. Then, in the picture on the far right, the lines around his mouth were "filled" with 2.4 ml (that's 3 syringes) of Juvederm XC.
Who is a good candidate for Voluma?
Juvederm Voluma XC treatments are safe and effective for all skin colors. It is ideal for those 21 years of age and older who would like to add volume to their face, particularly in cheeks, cheekbones, and jawline. Allergan does not recommend using this filler on people with thin skin. It should not be injected around the eyes or in the lips.
Is there anyone who should not get fillers?
- Women who are pregnant or breastfeeding
- People who have recently used blood thinners or have a bleeding disorder
- People on immunosuppressive therapy
- Anyone with a history of excessive scarring (keloid or hypertrophic)
- People who are allergic to lidocaine.
- People who have had previous severe allergic reactions that required hospitalization (anaphylaxis)
- People who are allergic to the gram positive bacterial proteins used to make these hyaluronic acid fillers
How much does Voluma cost?
Treatment can cost anywhere from $450 to $2,800. The price will vary by location and the qualifications of your injector. For example, a doctor will charge more to do injections than a nurse. Many offices will give a discount for multiple syringes of Voluma.

Generally, you pay by the syringe. The more syringes needed, the higher the cost. Allergan estimates that a typical patient, with average volume loss, should need 2 - 4 syringes. But this is dependent on how much volume their face has lost. A single syringe in one person can create a dramatic change. But that same dose might not even be noticeable on someone else.
Do you have any tips for someone new to Voluma?
It's best to start with a conservative approach. Use a smaller amount of Voluma, then add more later. The injected areas will immediately appear fuller, rounder, and have more lift. And that correction will only increase as your body makes new collagen. Your injector will ask to see you 2 – 4 weeks after your injections for a reassessment. That's the best time to discuss more injections.
Keep in mind that this filler lasts about 2 years. Future injections should require less Voluma to get the same result.
When comparing Voluma pricing to the cost for “wrinkle fillers” (which won’t deliver as long lasting or natural looking results), it is easy to see that Voluma delivers an excellent value.
Does it hurt?
Usually a topical anesthetic is applied before the injections. Voluma does contain lidocaine to decrease your pain. Patients who have had Voluma injections rated their pain a 3 on a pain scale of 0 – 10. (10 is the worst pain and 0 is no pain.) Voluma is also injected using a very fine needle, which decreases pain.

What are the side effects of Voluma?
The side effects of Voluma are uncomfortable, and generally last 2 to 4 weeks. The most common side effects are temporary reactions at the treatment site like tenderness, swelling, firmness, lumps / bumps, bruising, pain, redness, discoloration, and itching. As with all skin-injections, there is a risk of infection.
If a hyaluronic acid based dermal filler inadvertently gets injected into a blood vessel, it can cause significant side effects including skin breakdown, ulceration, or necrosis (death) of the skin. The risk of this happening is about 1 in 10,000.
There is an enzyme injection, hyaluronidase, that can immediately reverse those negative effects.
If you have any of these serious side effects, contact your injector immediately.
What care instructions are given after Voluma injections?
- No strenuous exercise, sun, heat or alcohol for 24 hours.
- Use ice packs briefly if treated area is swollen.
- Severe pain after injection is not normal. Contact your injector immediately if you experience this symptom.
- No swimming or skiing with goggles for 1 month.
- There is a possible risk of inflammation at the treatment site if laser procedures and chemical peeling are performed after treatment. Avoid these for 1 month.
- Sleep on your back for several nights after the injections.
- You may use Tylenol as needed for pain.
Your injector will want to see you 2 – 4 weeks after your injections for reassessment. That's the best time to discuss more injections.
Ready to Learn More About Fillers? Read These:
- Botox vs. Fillers | Which Will Work Best for YOU?
- How Juvederm and Hyaluronic Acid Fillers Add Volume and Soften Lines
- Everything You Need to Know About Lip Rejuvenation
- Lip Rejuvenation | Why Hyaluronic Acid Fillers & Medical Micro-Needling Get the Best Result
- Earlobe Rejuvenation - 2 Ways to Fix Stretched Lobes
- How Juvederm Fills Medium & Deep Lines
- Liquid Facelift vs. Surgical Facelift - Which Is Better?

Amy Takken, RN
Amy Takken is a registered nurse with 20+ years of experience helping people improve their health. Her in-depth skincare articles have been featured on Nazarian Plastic Surgery and The Palm Beach Center for Facial Plastic & Laser Surgery. She's also been quoted on Dermascope.com.
Amy loves research and constantly watches for new products and treatments to help you improve your skin’s health – because healthy skin is beautiful! To reach Amy, visit our contact page.
Masterpiece Skin Restoration is your online resource for all things medical aesthetics, skincare, beauty, and wellness. We keep you up to date on leading edge technology and the services available to help you restore your natural beauty.
We have all the information you need to restore your skin.
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References:
https://www.womenshealthmag.com/beauty/how-your-face-changes-as-you-age
https://www.charlottesbook.com/treatment/juvederm-voluma-xc/
https://www.allure.com/story/voluma-gets-fda-approval
https://www.medicinenet.com/script/main/art.asp?articlekey=124472 Age Takes Toll on Facial Bones, Study Finds
https://www.health.harvard.edu/healthbeat/why-your-face-ages-and-what-you-can-do
https://www.juvederm.com/treatment/cheek-fillers
TheChartBlogs dot CNN dot com - Aging Facial Bones Could Cause Wrinkles, Crows Feet
Disclaimer:
The Information provided on our website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some – like melanoma – can be deadly. If there is any doubt, please, please consult your physician. Thank you!