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Wrinkles and lines aren’t the only signs of aging. Over time, the cheeks flatten, and the skin may begin to sag. This is caused by a natural loss of volume in the cheek area, or what the experts call age-related midface volume loss. Juvéderm Voluma XC is designed to add volume beneath the skin’s surface to lift and contour the cheek area.
Why does volume loss matter?
Over time, your face changes in many ways. This is part of the normal aging process, but genetics and environmental factors also play a role.
You may notice a change in the appearance of your skin, typically in the form of deepening parentheses lines and wrinkles.
But what may be less obvious is age-related midface volume loss.
What are the signs of volume loss?
Juvéderm Voluma XC Approval Marks Significant Advance in Aesthetic Medicine
The FDA in October 2013 approved Juvéderm Voluma XC (Allergan), the first injectable filler approved to temporarily correct age-related volume loss in the cheek area in adults over the age of 21.
The approval represents a significant step forward in the world of aesthetic injectable treatments for a number of reasons.
In the past we’ve looked at fillers more from the standpoint of filling in the lines, starting with collagen-based fillers and eventually hyaluronic acids.
Over the last several years, however, injectors and researchers have increasingly looked at fillers in terms of replacing volume. As we age, we lose volume, and we see that the most pronounced is the mid-facial cheek area. If you look at a youthful face, one of the first things you notice is the volume of the cheek bone area.
The study that led to the approval of Juvéderm Voluma XC was a large multicenter trial in which researchers developed and used a validated scale, the MFVDS (mid-face volume deficit scale), to account for issues clinicians encounter daily in practice.
The trial involved live patient assessments which would set the precedent for how future trials in aesthetics will be. In addition to patient assessments, there were two blinded investigators who had to come to a consensus, which further validated results shown in the study. In the trial, Juvéderm Voluma XC yielded efficacious and durable results, with patients’ mid-facial areas experiencing volumization for up to a year.
That is due to an advanced manufacturing process—known as VYCROSS technology—that results in a smooth gel that flows easily and consistently. From a more scientific standpoint, the approval of Voluma will challenge physicians to continue learning about the utility of fillers, specifically regarding the developing concept of layering. As we learn to place some products more deeply, others moderately, and others superficially, the availability of a complex volumizing agent such as this will set forth a whole new approach and open up new concept pathways for mid-face volumization. That is why this approval is one of the major advances in aesthetics over the last few years.
Ivonne: Well, the lack of volume in the face worries many, but a new product approved by the FDA [Federal Drug Administration] promises changes. With us today is oculoplastic surgeon José Raul Montes to talk about this new product. Good morning. Welcome.
Dr. JRM: Good morning Ivonne.
Ivonne: First of all I want to congratulate you because I learned that you are the only one in Puerto Rico that has this product and are also training other doctors. What are the advantages of this product?
Dr. JRM: Well this product, the most important thing to understand is that this product is FDA-approved to restore volume in the midface area. Here is a skull that I brought today for you to understand. The midface area is basically the area under the eyes, and the whole area is what we know as the midface. In this photo, we see the middle facial area is marked starting from this circle that you see here. In women, the main design of this area is a little higher than in men. This is important because the projection in the middle facial area, having adequate volume in this area, is what gives the face a youthful look, and anteroposterior projection is defined as this curve that you see here [called the ogee curve].
Ivonne: Over the years, do we lose that volume?
Dr. JRM: This volume is lost over the years and not only that, some people [due to congenital reasons] do not have it. So this product brings a very important need because it is the only product designed and built with high technology to be injected into this area and produce changes like these that we see on screen. These are patient photos of before and after being injected with Voluma. Voluma is a hyaluronic acid. A hyaluronic acid is known as a polysaccharide; i.e., in layman’s terms, it is like the composition of normal sugar we have in the skin. It is a normal skin component and its function is to give structure to the skin and moisture [retains skin moisture].
Yvonne: Let’s move to the second case. I would like to point out: the change is not very dramatic; it is a subtle kind of change. Why?
Dr. JRM: This is the beauty of the product, in expert hands (so you have to be trained and have lots of experience injecting), produces subtle changes and gives youth to the person, reestablishes the midface volume with very subtle changes.
Yvonne: Let’s see another before and after image so that the public can benefit.
Dr. JRM: Here is a shot, basically ¾ profile, where the projection that is achieved is in the midface area, or what is known as ogee curve, that gives a more rested, fresher look, and therefore gives a younger appearance.
Yvonne: What about men?
Dr. JRM: Men are also candidates for this product. Here we see before and after photos of patients where another product that met this capacity before was injected [which is Sculptra]. We have talked about this product in the past here. Sculptra is injected in various sessions. The advantage we have with Voluma is that it is generally injected once and, yes, there may be retouches, but the expectation is that the patient will have results lasting for 2-2 ½ years.
Ivonne: Excellent! Thank you for joining us, doctor. Are there any contraindications for products like this, which is what people regularly fear?
Dr. JRM: Well, basically the contraindication for these products is people who are allergic to some of the components. This product has lidocaine, i.e., integrated anesthesia, which is an advantage because the patient will have a procedure that is basically painless, but if the patient is allergic to anesthesia then this may not be an option.
Yvonne: Well, thank you for joining us for today.
Dr. JRM: It is my pleasure.
With dedication and excellence, Dr. Montes lets his patients feel their most beautiful.