Bellafill swelling under eye 7 weeks post op (Photo)

Question

I had one syringe of Bellafil in my tear trough area 7 weeks ago. I'm getting very concerned because I look worse than I did before the filler. I never had eye bags before the filler, now I do. I saw my doctor (board certified plastic surgeon) for a 4 week post op appointment and he said it was still swelling. I got a second opinion with an oculoplastic surgeon and he also said swelling. I just cannot think I am still swollen at 7 weeks? What are my options?

Raffy Karamanoukian, MD, FACS · Answer

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

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

Elham Jafari, MD · Answer

Hi and thank you for your question! Bellafill is an excellent filler for the right place and I don't recommend it for under the eyes. My recommended fillers for tear troughs include Restylane Silk, Volbella and Belotero. In your case, your options include attempts at removing lumps using steroid injection and alike, and possibly further injections of hyaluronic acid fillers to better even out the results and conceal the lumps to some extent. I hope is helps and good luck!

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. Persistent swelling is one of the less common side effects of Bellafill. I always recommend working with a board certified facial plastic surgeon so you should remain patient and trust the advice of your surgeon. Please follow all post op care instructions and consider making another in-person appointment to discuss your concerns.Best wishes,

Jason Emer, MD · Answer

It can take several months for final results with Bellafill. However, 5fu/steroid injections and venus legacy/viva treatments can help soften results. See an expert. Best, Dr. Emer

Faraz Valaie, MD · Answer

Sorry to hear that you had a bad experience, 
Can you kindly specify how many days after the injection the swelling happened? Also in the past 4 weeks (since you posted this) do you see any improvement or change?
One last thing... can you please upload a before the procedure photo?
This will help to answer you more precisely :)

Steven F. Weiner, MD · Answer

I think what you have won't go down if you just wait. I would treat with 5FU and Kenalog. This will cause some swelling initially but should improve the problem. Oral steroids can be tried as well. If there was HA filler in the eye area before, I would use hyaluronidase before anything else.

Brian Windle, MD (retired) · Answer

I am sorry to hear that you have had this problem.  From your photos, it appears that you have a condition called peri-orbital edema.  It is a very hard condition to understand and explain and even more difficult to treat.  It is essentially, chronic swelling of the lower eyelids that was unmasked by the injury from your Bellafill injections.  if it is worse in the morning and gets better during the day, then it is very likely that this will settle in time.  When this has happened in my patients, I generally wait at least 16 weeks before intervening.  Most of the time the problem will resolve on its own.  There is no treatment for peri-orbital edema but if need be, on a rare occasion, I will perform a very conservative pinch blepharoplasty under local anesthesia to tighten the skin.  This masks the problem very nicely.I hope that helps.Best regards.

Bellafill swelling under eye 7 weeks post op (Photo)

Answers (7)

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