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

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. It sounds like you experienced a serious and unfortunately not uncommon complication from Bellafill, a permanent filler made of PMMA microspheres suspended in collagen. While Bellafill can offer long-lasting results, it requires extreme precision and should only be used in specific areas and by highly experienced injectors due to its permanence and risk of long-term adverse effects. The reaction you described—significant immediate swelling, facial distortion, and a growing lump—suggests an inflammatory or granulomatous response to the product, especially given that it persisted despite steroid treatments. The fact that the injector switched products without clear consent or discussion, and dismissed your concerns, is deeply problematic. Unfortunately, once Bellafill has integrated into tissue and formed a granuloma or nodule, it cannot be dissolved like HA fillers, and surgical excision is often the only definitive treatment. I hope this helps and best of luck!

Hi! Dr. Peterson here —
I’m really sorry you’ve been dealing with this. Bellafill is a permanent filler made with PMMA microspheres, so it can’t be dissolved the way hyaluronic acid fillers can. That permanence is why most of us reserve it for very select cases and always with thorough counseling.
A lump that’s persisted and grown despite steroid injections sounds like either granuloma formation or a scar tissue response to the filler. Unfortunately, these reactions often don’t resolve with injections alone, and in many cases surgical removal is the most reliable option.
One other point to consider: if you have other filler in your lips or surrounding areas, it may be worth discussing dissolving that with your dermatologist. Sometimes the body reacts to one filler and this can worsen the overall inflammatory process. A “reset” back to baseline can be helpful before starting fresh in the future.
The next step would be a consultation with a board-certified dermatologist or dermatologic surgeon who has specific experience managing permanent filler complications. They can guide you on whether excision, further medical management, or a combination is the best path forward.

I am really sorry that you are going through this. However, unfortunately, problems, such as yours, are not uncommon complications of treatment with permanent fillers, such as Bellafil, silicone, and even fat injections, which is why I do not use any of these permanent fillers. Basically, permanent fillers can translate into long-term or permanent complications that may occur after injection, but even five, ten or even twenty+ years following treatment, especially if the treated area is subject to later trauma or manipulation, such as during dental procedures. Really sorry.
Surgical removal is certainly an option. However, surgery can leave stretch scars and stitch tracks, especially in facial areas subject to a great deal of facial expression movement or to static muscular tension.
I have treated quite a few patients coming to me with complications, such as persistent nodules, granulomas and disfigurement resulting from the use elsewhere of permanent fillers for whom I have been able to help using an algorithm of varying combinations, concentrations, and amounts of intralesional anti-inflammatory agents.
You would be wise to consult with an experienced, board certified cosmetic dermatologist injector expert. Hope this helps and best of luck.

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.