MAR 2014

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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DETAILS POST-TREATMENT CARE After treatment, I apply ice for 30 to 60 minutes and ask patients to avoid self-massage and excessive exercise, heat and alcohol for at least one day. Common side effects include redness, tenderness and lumps. To prevent bruising and accelerate healing, I now recommend all my patients use Cearna OcuMend Anti-Bruising Healing Gels ( Nevertheless, depending upon the amount of injection trauma to tissue, it may take a few days for one's appearance to be socially acceptable, especially for television, modeling or special occasions. A brief follow-up appointment a week later may be helpful for additional sculpting. One VOLUMA treatment should lift the patient's cheeks for two years—unlike other cosmetic injectable fi llers, which would require two or three treatments to last as long. My VOLUMA patients love their results and the potential longev- ity of treatment. But, the higher initial cost has led many of them to remain with JUVÉDERM Ultra Plus XC. Moreover, each practice will need to balance their initial income from VOLUMA patients against their absence from additional cosmetic fi ller treatments over the next two years. My clinical assessment of Allergan's hot new product? The handling characteristics are similar to JUVÉDERM Ultra Plus XC, but VOLUMA does require a trifl e more pressure for extrusion. Being thicker, it is less malleable to massage but because it is injected well below the dermis—ranging from the supra-periosteum to subcutaneous plane—there is less need for sculpting. And it is this same stiffness that allows us to build the structural foundation we need. The tradeoff with VOLUMA is that the deeper you go, the more natural the appearance, but you may need more product to achieve the desired effect. This may be off-set with better placement techniques. As I suspected, it works beautifully with the STERiGLIDE MicroCannula, which allows for precision placement with minimal patient discomfort and bruising. The key with VOLUMA is that you need to care- fully select your injection sites and master your injection technique to create the desired effect, or you will consume far too much product for the results obtained. My clinical impression is that VOLUMA is superior in its ability to hold its shape—but less hydrophilic than Allergan's JUVÉDERM Ultra Plus XC and Medicis' Perlane and Restylane, resulting in a bit less volume per syringe. Of course, the singular advantage is that results may remain for up to two years. Garry R. Lee, MD, is the medical director of Aes- theque in Henderson, NV. Contact him at The vertical fan injection technique provides lift without creating a palpable superfi cial presence of fi ller. After injection, the physician can sculpt the VOLUMA to achieve the desired aesthetic effect. The deeper you go, the more natural the appearance, but you may need more product to achieve the desired effect. 26 MARCH 2014 | Med Esthetics PHOTOS COURTESY OF GARRY LEE, MD D e t a i l s M E D 3 1 4 . i n d d 2 6 Details MED314.indd 26 2 / 1 1 / 1 4 3 : 5 0 P M 2/11/14 3:50 PM

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