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Management of Facial Filler Complications: Juvederm Voluma and Vollure

Facial filler complications


Juvéderm Voluma and Juvederm Vollure are among two new hyaluronic acid facial fillers that have entered the aesthetic market. It is necessary to understand the complication profile of hyaluronic acid's when injected into the face. Complications include granuloma formation, Long-term swelling, bruising, lumpiness, and infection. Hyaluronic acid facial fillers can cause long-term tissue edema and inflammation that may be associated with pain and tenderness.


There are reasons to undergo immediate treatment for facial filler complications and there are reasons to forgo aggressive intervention in favor of conservative management. Facial filler complications from Juvéderm products can be long-lasting and can cause both medical and cosmetic complications. Symptomatic complications that involve pain and chronic swelling require more immediate intervention.


Dr. Raffy Karamanoukian is a world renowned specialist in the management of permanent filler and Hyaluronic acid filler complications. Although he advocates conservative management of facial filler complications, he is keenly experienced in the surgical and injection based management of severe complications arising from facial fillers.


Juvéderm products contain hyaluronic acid and can often be reversed with Hayaluronidase enzyme injections to melt away the unwanted facial fillers. These products include Vitrase and Hylenex to reverse and melt away HA fillers. There are many cases in which a patient does not know which type of fillers that were injected. In these situations, forensic pathology biopsies are often performed to determine the identity and material used in the facial injections. Filler types include silicone, liquid silicone, biopolimero, biogel, Artefill, Artecoll, and Bellafill.


The management of granulomas begins with a diagnostic examination followed by conservative injection based therapy to dissolve and reduce the size of the granulomas. In some cases, surgical intervention is indicated to remove the granulomas with minimal scarring.


Chronic inflammation and tissue swelling is a difficult problem to resolve unless the causative agent is removed and it's entirety to reduce localized inflammation. The removal of the material can be surgical or injection-based and depends on the material used to inject the face.


If you are having problems with facial filler injections including Juvederm, Restylane, liquid silicone, or any other type of cosmetic facial fillers, 

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