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.