Bellafill Lumps - how can these lumps be removed? (Photos)

Thank you for sharing your experience—what you’re going through is understandably frustrating and unfortunately not uncommon with permanent fillers like Bellafill.

Why Bellafill Lumps Occur
Bellafill is a permanent filler made of polymethyl methacrylate (PMMA) microspheres suspended in collagen. While it can provide long-lasting volume, it cannot be dissolved like hyaluronic acid (HA) fillers.
Lumps or nodules may form due to:

Overfilling or incorrect placement

Inflammatory response to the PMMA microspheres

Migration or encapsulation of the filler

Trauma to the tissue during injection (as you described)

Common Treatments (and Their Limitations)
1. Intralesional Corticosteroid Injections
These can reduce inflammation and soften granulomas, but they may not eliminate larger or well-encapsulated lumps.

Multiple sessions are often required and success is variable.

2. 5-Fluorouracil (5-FU) Injections
Sometimes used with steroids to reduce nodule size in combination.

Works better on inflammatory nodules, less so on fibrotic lumps.

3. Surgical Excision
In cases like yours, where the lump is firm, persistent, and unresponsive to injections, surgical removal is often the most effective option.

This involves excising the lump directly and possibly reconstructing the area to restore a smooth contour.

The success depends on the location, depth, and surrounding tissue involvement.

Additional Considerations
A radiologic scan (such as ultrasound or MRI) can help confirm the filler location and guide treatment.

The original injector’s suggestion that “traumatizing the area” was part of the plan is concerning—Bellafill should be injected with care, as trauma can lead to overactivation of the body’s immune response, resulting in granulomas or fibrotic lumps.

Since Bellafill cannot be dissolved, the presence of a hard, persistent mass more than a year post-injection is most consistent with product-related nodule formation.

Summary
Given that corticosteroid injections have been ineffective and the lump is growing, surgical removal is likely the most definitive and effective solution. While invasive, it offers the highest chance of resolving the issue and restoring a more natural contour.

This situation underscores the importance of fully informed consent and thorough discussion before switching to permanent fillers. You're not alone—many patients have encountered similar challenges with Bellafill, and a skilled facial plastic or dermatologic surgeon experienced in filler complications is typically required for resolution.