Tag Archives: injection techniques

Juvederm Voluma Injection Notes according to an Expert outside of the US

Tonight I participated in a live lecture on the web regarding Juvederm Voluma injection techniques.  I guess they call this format a webcast or webinar.

I joined a few minutes late.  But it seemed to start with a discussion of facial muscle anatomy followed by a discussion of facial fat compartments.

Here are my notes below for other Botox  injectors and Juvederm Voluma injectors if interested.  My personal technique is somewhat different because I use a cannula technique and he uses a direct needle technique.   Cannula technique at this time is considered off-label FDA usage.  But I feel that it is, in my hands, a safer technique.


Some Juvederm Voluma / Cheek filler highlights:

  • Lateral support is important – at the level of the zygomatic arch.
  • Females have fuller frontal cheek projection it seems than males.
  • Anterior cheek injections can unfortunately reinforce the ptosis of the cheek.
  • Cheeks become lower and more medial when smiling with age – age 40 vs age 50
  • With volume loss in the submalar area – danger sign for “sausage” look with nasolabial filling
  • The nasal flare shouldn’t be hidden with injections – avoid medial cheek injections.
  • People who may look good in the frontal view, might not look good in the oblique view.
  • Aspirate when injecting deep with Voluma
  • With infection risk, there is granuloma risk.
  • He labels the zymatic arch with v1, v2, v3
  • v4 is the soft area of the cheek below v1, v2, v3.
  • v=voluma
  • avoid treating v4 first because of lack of bone support.
  • He uses a pull upwards and backwards = “pinch traction” so the skin cannot go back to it’s original tendency after placement of voluma
  • A discussion of J1, J2, J3, J4.  These are Juvederm locations.
  • He talks about J4 as the vertical lip rhytids (lines) and talks about perpendicular injection to avoid elongation he says.
  • At Voluma injeciton site #4, there are many dangerous sites such as parotid gland, parotid duct, or the transverse artery.  He uses a fanning technique for injections.
  • Look at patients on animation and when looking down.  Animation meaning smiling.
  • Avoid voluma intra-orbit.
  • Malar crease – you can solve some of the ones which disappear when the patients smile.

Great presentation!  There is always much to learn from other Voluma injectors.

Disclaimer:  The above notes are not my thoughts.  They come from a surgeon who works outside of the United States.  They are interesting and I thought I’d share.  The talk on Juvederm Voluma was brought to us by Allergan.