Bellafill safety - could it cause nodules and other complications?

I gave up injecting permanent fillers a long time ago when the first natural collagen fillers were approved for use. The reason: permanent fillers have been well known to give rise to adverse reactions, not only immediately following injection, but to nodules and granulomas five, ten or twenty plus years later, especially if trauma or dental manipulation occurs to the cheek or region were they were injected leading to their being razzed up. And while I have treated many such patients (treated with the permanent filler elsewhere) over the years, it is typically difficult and requires many treatment sessions.
It needs to be understood that permanent fillers, unlike natural HA-based fillers, are essentially foreign bodies being injected into the skin to elicit fibrosis (which is how they elevate the skin and why several treatment sessions are typically needed to achieve optimal aesthetic results with them). Furthermore, even if they do not cause the above complications, knowledgeable and prudent doctors are unlikely to want to use even natural fillers in the region where permanent fillers have been injected, so as not to razz them up. So, while the idea of "permanent" is admittedly enticing, it would be wise to keep in mind the title to my answer when considering treatment with them. Hope this helps. Best of luck.

Our treatments use combination therapy to improve complications associated with Bellafill, a filler with permanent attributes that can cause granulomas, uneven contour, and soft tissue reaction. Our office focuses on granuloma reversal in cases where an incision may leave permanent scars. The reversal is performed with Kenalog IIT combination therapy, fibrous release, and HIDEF fractional RF to help break up the nodularity. Schedule a consultation for surgical removal if the Bellafill is located in the eyelids, lips, and lower face. Midface Bellafill is difficult to surgically remove.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Bellafill is a dermal filler that contains both collagen and polymethylmethacrylate (PMMA) microspheres. It's primarily used for the correction of facial wrinkles, such as smile lines or acne scars. While Bellafill is generally considered safe and effective when administered by a trained and experienced healthcare provider, like any cosmetic procedure, it carries some risks and potential complications.One of the main concerns with Bellafill is the formation of granulomas or nodules. Granulomas are small, inflammatory nodules that can develop in response to the presence of foreign materials, such as the PMMA microspheres in Bellafill. These nodules may appear as firm bumps under the skin and can sometimes be palpable or visible.Although the risk of developing nodules with Bellafill is relatively low, it is still a potential complication that patients should be aware of. Factors that may increase the risk of nodules include:1. Injection technique: Proper injection technique by a skilled and experienced healthcare provider can help minimize the risk of complications, including nodules.2. Patient factors: Individual patient factors, such as a history of hypersensitivity reactions or autoimmune conditions, may influence the likelihood of developing nodules.3. Location of injection: Certain areas of the face may be more prone to developing nodules than others. For example, injections near the lips or eyes may carry a slightly higher risk.4. Volume of filler: Using excessive amounts of filler or injecting it too superficially can increase the risk of complications, including nodules.5. Post-treatment care: Following post-treatment instructions provided by the healthcare provider can help reduce the risk of complications and promote optimal healing.It's essential for patients considering Bellafill or any other dermal filler to have a thorough consultation with a skilled healthcare provider. During this consultation, the provider can assess the patient's medical history, discuss potential risks and benefits, and develop a treatment plan. Patients should also be vigilant about monitoring for any signs of complications after treatment and report them to their healthcare provider promptly.Overall, while Bellafill is generally considered safe and effective for the correction of facial wrinkles, including smile lines and acne scars, it's essential for patients to be informed about the potential risks and complications, including the formation of nodules, and to work closely with an experienced provider to minimize these risks.

Yes, the patients can have delayed onset reactions to Bellafill with nodules or swelling months or years later. Unfortunately, since it is composed of PMMA particles, it is impossible to dissolve or remove without surgical excision. Hyaluronic acid fillers can cause delayed reactions as well, but we can remove them by dissolving with hylauronidase. We do most of our dissolving ultrasound guided. Ultrasound can show you exactly where the filler is, better than any other imaging studies.