Allergan’s JUVÉDERM VOLUMA™ XC: A Promising Product for Cheek Augmentation – If Used Properly

I’m excited to hear about the new release of Allergan’s JUVÉDERM VOLUMA™ XC product for deeper-level facial augmentation. The company is proposing the use of this product for cheek augmentation to impart a younger look, and they mention (correctly) that improving the cheeks can also improve the nasolabial folds without having to add as much volume back to them directly.

Along with my excitement, however, comes a concern. While this product shows great potential, I worry about its misuse by those who don’t understand the importance of achieving full facial balance.

Not Seeing the Forest for the Trees

A big concern I have about the release of this new product, and the FDA indication for cheek enhancement, is that unsophisticated practitioners will be focusing primarily on rejuvenating the cheeks instead of focusing on rejuvenating full facial balance. This could lead to some awkward results in patients.

I’ve seen too many patients in my office who have been chasing youthful cheeks while ignoring the rest of the areas of the face that need volume restoration. Some have even found doctors who were willing to treat them. Unfortunately, there are doctors out there who are happy to give patients whatever they ask for without educating them first on the importance of full facial balance. It’s these doctors whose patients often look “like they’ve had work done.” (Think of the people you may have seen with exaggeratedly plump lips or extremely drawn-back eyebrows.)

The results of these one-sided procedures, unsurprisingly, are less than optimal:

Some patients come to see me with cheeks so enhanced their faces appear strange. This is because their cheeks are out of balance with the rest of their face; they (and their doctors) were focused only on that one area, and not on the importance of achieving natural, balanced harmony throughout the entire face.

This photo is an example:

Here, the cheeks are those of a younger woman, while the temples and the infra-cheek region indicated a woman much older. This face doesn’t make sense from a proper facial balance perspective. The subconscious brain, when looking at this photo, sees youthful cheeks in an otherwise older face, and this disconnect is disconcerting.

Focusing on the Whole, Not Its Parts

Restoration of lost volume is a powerful way to rejuvenate a person’s face, but it must be done with a global approach towards proper facial balance.

While I do think that Allergan’s JUVÉDERM VOLUMA™ XC can be a useful tool in helping achieve this balance, currently I like using a product called Sculptra® for helping my patients achieve this balance.

For instance, when I recently visited The Howard Stern Show to offer suggestions for facial improvement to the show’s staff, I noted that Howard would be a great candidate for the Sculptra® facial volume replacement treatment. This product is injected into the face to restore volume in places where volume has been lost. It creates collagen around the areas of the face where the Sculptra® particles have been placed, and it works gradually and naturally, with results that last for years.

I like this product for my patients who are in the public eye, such as TV reporters, because they can’t show up on TV one evening with an instantly changed appearance; gradual improvement over weeks is more appropriate for them. By restoring the lost volume in the face, patients’ non-verbal communication gives off a younger and more energetic appearance, without the incongruent messaging caused by only attending to one specific area of the face while ignoring the rest.

In my practice, I apply classic beauty ratios to my approach to facial rejuvenation in a protocol I call Perfect Proportions. This allows me achieve results for my patients which are powerful in their impact, yet subtle at the same time. Patients don’t have to worry about looking like they’ve “had work done”; they simply look like a better, fresher version of themselves. It’s still them, only enhanced.

It’s my hope that more practitioners using facial fillers will learn to focus on this balanced approach.