We are seeing many longterm problems associated with permanent fillers in our office. Complications from silicone biopolymers, Artefill, Bellafill, PMMA, and biopolimero should be addressed by an expert in the field. In my practice, I specialize in the removal of Bellafill and Artefill injections, in addition to silicone biopolymers, from the face and body. Initially, treatments are non-surgical with corticosteroids and immune modulators. If unable to be corrected, we can also perform surgery in some cases. Patients should undergo biometric screening, clinical assessment of Karamanoukian Grade of Soft Tissue Reaction, and ultrasound examination. Silicone biopolymers can also be removed from the body if there are signs of migration or inflammation. All of these filler-types should be removed as early as possible. Lastly, our office is conducting ongoing studies of plasma-assisted corticosteroid application, which allows for diffusion of the treatment medication in superficial tissue without causing atrophy. Best, Dr. Karamanoukian Realself100 Surgeon