Friday I was asked to perform a master training course on Voluma with a world-reknown plastic surgeon from Brazil. He had the classic Latino vibe, complete with the Brazilian accent. That started the day out well. By the end of the day, I felt like I had gone back to medical school for the day. Things I had always known, or had learned in the last eight years of practicing cosmetic dermatology were changed both in subtle and dramatic ways.
First, we analyzed six patients—spending time to determine the facial shape (oval is best), the symmetry both vertically and horizontally, and how ethnicity can truly effect proportions of aging. We looked at hairline, the set of the eyes, the texture and health of the skin of the face and neck, the volume of the mid face and lower face, the placement, size and shape of the nose, the volume and shape of the lips, and the lower jaw line and chin in regards to sagginess and volume. With one patient, we spent approximately one entire hour of dissecting her particular facial anatomy. (I am sure that was quite pleasant for her!)
Some of the patients were quite difficult—narrow and square face with close-set eyes or broad cheeks and squared off jaw line with a complete loss of chin (not a small chin, but lack of chin). Some were easier, despite the advanced age of 70. Thus, one myth is eliminated: Advanced age equates to less beauty. Not necessarily!
By asking ourselves does this patient need to look younger or more beautiful, we determine our goal of the cosmetic rejuvenation. If they look older than their stated age, the primary objective is to determine how to make them appear younger. If they look appropriate for their stated age, the goal should be beauty. How do we make them look like themselves, only better?
Next, we determined the most saggy side of the face, and injected a small pea size amount (0.1ml) of Voluma to the V1 location of the zygomatic arch. The injection took minutes, but the 2nd evaluation of every patient took another 30 minutes. We looked at the improvement at rest, which was definitive despite the small amount of product, but more amazing, was the variety of muscle movements and lines created with movement, such as smiling, puckering or frowning, which improved with such a small amount of product. Second myth eliminated: By filling an area of the face, we are simply filling that area. Wrong. By filling one area of the face at the level of the bone, we literally re-construct the way that the surrounding areas of muscle and fat interact with one another and create dramatic impact with little volume. This was further emphasized with small amounts of Voluma placed in various locations according to the patient’s face.
Finally, we got the true measure of success from the people that really mattered the most: our patients. Did they look younger or more beautiful? Many reported looking at least 10 years younger, and one reported that she felt younger and more beautiful!
Sometimes, patients really do have insight into what is happening with regards to their aging face, but many times, they ignore facial deficits that have been there for so long that they have become ingrained in their mind as “normal” or “acceptable”, not realizing that one day there would be a product that could, in fact, overcome issues related not simply to volume loss but also to the workings of muscle and facial fat. Voluma…a revolutionary new product that will change the way that I look at the aging face. Who said you cannot teach an old dog a new trick?
Authored by Dr. Ellen Turner, Dermatology Office of Dr. Ellen Turner, M.D., Dallas, TX