Is Bellafill a good or bad long-term solution?

Filler migration and granuloma formation can cause longterm problems with Bellafill and Artefill fillers. This is similar in patients who have Artecoll and PMMA fillers. Longterm filler complications include migration, edema, chronic swelling, and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes, corticosteroids, and scar tissue modulators. Our HIDEF approach can break down filler scarring and granulomas so that they are less apparent. If the filler material itself does not dissolve, it either means the filler is likely not HA material or is unresponsive to conservative therapy. This technique may be followed by surgical removal of the filler if there is a suitable target for removal and the chance of scarring is low.

Surgical removal of Bellafill is possible and we have a wide ranging experience with the treatment. Some areas of the face can be treated because the Bellafill removal scars are barely visible. We have found that Bellafill nodules, if palpated, can be removed from the tissue. Undereye Bellafill, nasolabial fold Bellafill, and lip filler can be treated successfully. Diffuse Bellafill is difficult to treat.

Best,
Dr. Karamanoukian
Realself100 Surgeon

So far I have used this product for the last 3 yrs and have found it to be an excellent solution for long term replacement of facial volume loss.  I always perform pretesting to r/o bovine collagen allergies.

Bellafill is a great product used only by an advanced injector that has experience with long lasting fillers. It's best to have a consultation with your doctor to find out all the pros and cons of Bellafill vs. other fillers. Bellafill contains collagen so patients need to be allergy tested to make sure they are not allergic. Also, Bellafill is longer lasting and is not removable vs. hyuloronic acid fillers such as juvederm and restalyne which can be removed easily with an enzyme. 

Bellafill has been studied longer than any other filler. With over 675,000 syringes, the complication rate is 0.14% long-term. With any type of filler there will be complications, even with HA fillers. The absolutely most important factor in this product is the injector. This needs to be sterilely injected with cannulas for optimal safety. I have 8 syringes in my face so I believe in this product. The aging face will continue to loose volume so more filling is going to be needed to maintain your look as you get older. It is a matter of maintenance. I have many patients which look the same or better after being with me for the past 10-15 years by doing regular anti-aging treatments including filler, neuromodulators, lasers, RF, and skincare. I call it "age freezing".

Bellafill is an amazing product. It lasts for 5 years, so patients love it. It has also been studied heavily and studies show it has a great safety profile. You may be referring to Artoplast and Artocol which were older forms of PMMA which caused issues and were never FDA approved. You do not need surgery to remove Bellafill. There are other ways of minimizing it. 

Yes!  In my opinion, it is a great long-term solution because it has the greatest value.  First of all, it is a safe option with a very low complication rate.  It has been around since 2006 (was called Artefill).  With age, you lose more facial volume due to collagen loss and skin loses elasticity.  Mother Time is not kind to our faces.  You will want to replace further volume loss with additional filler. In the hands of doctors with expertise in injecting fillers, the filler gives a very natural look.  Does not look fake at all.  Patient satisfaction in my practice is 100% and no patient has expressed regrets to date.

Bellafill is the most studied and has the longest continuous data of all the fillers. The 10 year safety profile was just published and it is still the safest filler on the market. Most filler studies stop at 2 years. Unfortunately it is often confused with other related fillers that never passed FDA clearance so are only legally used outside the US. It will not migrate and most of the side effects noted occur within the first few days (allergy) or the first year (nodules or localized infection or biofilms). These have also been reported with all the other fillers. It has been followed for 15 years and no problems with adverse aging are seen. Occasionally a nodule of scar tissue becomes visible and must be injected or excised.

Hello and thanks for posting.
Bellafill is a combination of bovine (cow)
collagen and PMMA. The PMMA microspheres
are the permanent component of Bellafill. 
Bellafill is currently approved for naso-labial folds and acne scars,
but has been safely used in “off-label” locations since it was approved in
2006.  
The
main safety issue with Bellafill in the risk of late granuloma formation.
Granulomas are late development of nodules in the areas of injection.  When
Bellafill was approved by the FDA a 5 year post-marketing safety study was
mandated. This study showed that there was a 1.7% risk of granuloma formation
over 5 years (17 of 1000 patients developed granulomas in this study).  Granulomas are not related to injection technique,
but represent an aberrant immune response to the PMMA.
Granulomas
are manageable, a series of injections of triamcinolone and 5FU reliably
shrinks the nodules down. There are also data from Europe and China suggesting
that deep injection of PMMA onto bone further lessens the risk of granuloma formation
because of the scarcity of immunologic cells in this anatomic location. Surgery
is almost never indicated for management of granulomas. 
Another
potential complication from Bellafill are nodules, these tend to be related to sub-optimal
injection technique and represent a clump of injected Bellafill. Nodules will
often improve with injection of triamcinolone was well.
With
regard to Bellafill looking odd as the tissues age around it, this has not been
a problem, although this product has only been available for just over 10
years.
Bellafill
is a safe and effective long-term filler and has benefits over short-term
fillers. That said, it should only be injected by highly experienced facial injectors
who understand the potential for rare, but significant late complications.
I
hope that this information helps and best of luck to you!