Both Bellafill and Sculptra are known as particulate fillers
but Sculptra fills by adding a lot of particles which eventually get absorbed
while Bellafill works by initially filling with collagen which is eventually
replaced by your own tissue because of the tiny microspheres (cell size)
contained in Bellafill that promote collagen formation. The results you had at the time of your
injection (immediate) are the results you should eventually get. A few minutes after the injection however,
you will start to swell and it takes about 3 to 10 days for that to all settle
down but it will not settle back to where you were prior to your
injection. Many injectors are a little conservative
with the amount they use because you cannot take Bellafill back and it is not
The good news here is that if you feel you need more,
whatever you had will act as a good base for adding more.
I hope that helps.
Although Bellafill does result in some delayed filling effects you certainly should see some results at 4 days later. All of the collagen should not be absorbed at that point. So it is very possible that you simply need more filler. Certain parts of the face, the cheeks or deep nasolabial folds, can often require more filler than expected. Of course any filler gets expensive as their is a cost for each syringe so sometimes if I know that a patient needs a substantial amount of volume correction than I will encourage them to do a fat transfer. Obviously it is hard for me to give you too specific advice without seeing pictures or knowing the details of your injections but my guess is that simply more volume is needed. Otherwise Bellafill is a very reliable fillers and can provide great results.
Bellafill and Sculptra are both stimulating agents that require multiple treatment sessions to obtain gradual results over time. There is some immediate fill from both agents, but this is fairly short lasting. The long term filling gradually occurs over time and can take a month or two to reach the full effect.
You are correct in everything you have said. If the correction is not evident after the fill with Bellafill, it is unlikely that after a few months that there will be much difference. The Bellafill is Bovine 80% collagen that is broken down by the body and the PMMA stimulates your own collagen. The "replacement" collagen is usually equal to what was originally seen with the correction. Sculptra is also a collagen stimulant, but doesn't have any visible correction (after the first 48 hours) until your own collagen kicks in. Sculptra is more "robust" than Bellafill, leading to larger corrections.
BellaFill uses bovine collagen which will provide you with an immediate result and should last around 3-4 months. There is a low point in which the collagen has been absorbed and your own collagen production is occurring. If you are not seeing the results desired it is probably due to a lack of filler, most aging patients will need more than one kit (5 Syringes) of BellaFill.