title: Clinical Experience With 11,460 mL of a 20-mg/mL, Smooth, Highly Cohesive, Viscous Hyaluronic Acid Filler.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Departments of *Dermatology and Skin Science, and †Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Shannon
authors.initials: S
authors.lastname: Humphrey
authors.forename: Jean
authors.initials: J
authors.lastname: Carruthers
authors.forename: Alastair
authors.initials: A
authors.lastname: Carruthers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003357:Cosmetic Techniques; D004954:Esthetics; D005145:Face; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007267:Injections; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012060:Rejuvenation; D012189:Retrospective Studies; D015595:Skin Aging
chemical_list: D006820:Hyaluronic Acid