Clinical Experience With 11,460 mL of a 20-mg/mL, Smooth, Highly Cohesive, Viscous Hyaluronic Acid Filler

BACKGROUND: A 3-dimensional approach to facial rejuvenation restores volume lost over time. Hyaluronic acid (HA) filling agents provide long-lasting correction with minimal side effects and a high level of patient satisfaction. The newest HA formulation is a 20-mg/mL smooth cohesive filler (Juvéderm Voluma [HA-V]) that combines both low- and high-molecular-weight HA for more efficient cross-linking and greater lift capabilities. OBJECTIVE: To document the clinical experience with HA-V over the course of 68 months. MATERIALS AND METHODS: The authors conducted a retrospective chart review of patients who received HA-V for facial augmentation between February 1, 2009, and October 1, 2014. Clinical results were assessed 2 weeks after initial treatment, with touch-ups performed as necessary. Color photographs were taken before and after treatment, and adverse events were documented. RESULTS: Over 68 months, the authors treated 2,342 patients with 11,460 mL of HA-V. Aesthetic results lasted upwards of 12 months, and most side effects were transient and mild. Three patients developed signs of vascular compromise that was promptly treated and resolved within 2 months. Twenty-one patients (<0.5%) experienced late-onset, temporary, nontender nodules that were successfully managed with conservative measures. CONCLUSION: Easy to use and well tolerated, HA-V is ideally formulated for soft-tissue augmentation in the face, with clinical effects lasting 12 months or longer.