Is there a problem with Bellafill?

Bellafill is more permanent than other fillers and thus it requires meticulous injection technique and someone skilled and experienced.  Some physicians do not use this product for those reasons.  I use a significant amount of this product and find it very useful and beneficial for patients. Best, Dr. Emer.

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

Thank you for the question. Bellafill® is composed of 80% bovine collagen and 20% polymetylmethacrylate (PMMA) microspheres. Bellafill® is considered a semi-permanent filler and has 5-year post-FDA approval safety data published.  It is a very useful and long lasting filler, but it is difficult to reverse so you need a highly experienced injector.  Also, you’ll need a skin test to be sure you're not allergic to the collagen component.
As always, an in-person consultation with a board certified dermatologist with cosmetic training is the best way to assess your needs and provide medical advice. 

Many practitioners are generally more comfortable with standard hyaluronic acid fillers (like Juvederm and Restylane) because they ultimately can be dissolved should the results not be as they had intended. Because Bellafill cannot be dissolved, and if it is poorly placed, the practitioner doesn’t have many options other than perhaps placing more filler to correct any unintentional issues. With that said, we use a lot of Bellafill in our office and our patients love it!

Some doctors are reluctant to do it because it produces long-lasting effect.  Administering Bellafill requires a high level of injection expertise.  That said, in my experience Bellafill handles beautifully and creates very impressive results and our patients have loved it. Find a doctor who has experience with it and will take a conservative approach. 

As others have already said, Bellafill is a long term filler and some MD's are wary of placing it patient's faces because of this.  I have been an injector of Bellfill for over a year now and have seen very nice, long lasting results.  The doctor does have to have very good, sterile technique, and a good artistic eye since this filler cannot "technically" be removed once placed.  However, don't let that frighten you because a good injector knows there are almost always techniques available to correct the rare occasion of a patient who is unhappy.  This product is very safe and has proven research behind it. I think many physicians just feel it is easier to do reversible fillers but if you can find an injector in your area to use Bellafill, I think you will be happier in the long run. Best of luck!

Bellafill is a safe long term filler when used correctly.  There may be several reasons that some doctors do not use the product.  Because the result of Bellafill is long term, it does require a bit more experience in injecting it than most of the other fillers.  Also, some physicians may shy away from it because they are concerned that they cannot dissolve the product if the result is undesirable.  If the treatment is done carefully and gradually, the result should be satisfying to the patient.  

Bellafill is a specialty filler and requires a much higher degree of skill and knowledge of anatomy than most of the temporary fillers like Restylane, Juvederm or Radiesse. Unlike the companies that manufacture Botox and Restylane and target just about every potential injector, the company that manufactures Bellafill is more focused on the extensive training of their Bellafill doctors. With Bellafill being a 5 year filler, its important to do it right the first time around. Unlike treatment with a temporary filler, which lasts months to a year, your doctor cant tell you that Bellafill will go away soon, in the event of a poor result. So if your going to have Bellafill, go to a plastic surgeon who is not only board certified, but also specializes primarily in the face. Make sure your surgeon performs not only a high volume of injectable filler treatments but, more importantly, specifically performs a high volume of Bellafill treatments. By going to a BellaDiamond injector who performs about 500 to 600 syringes per year of Bellafill, your increase your chances of a good result. With speciality products like Bellafill, it is not so important to find many doctors performing the filler. It is more important to see a highly experienced Bellafill injector.

Bellafill has been shown to last at least 5 years with their recent study. It requires a skilled physician to inject because it is so long lasting. The company trains each provider how to inject it with very experienced physicians (I am a trainer). Some physicians don't feel comfortable with such a long lasting filler and choose not to offer it. There are a couple reasons for this. One is that they aren't familiar with the recently published 5 year safety data. Two is that they are not comfortable with their technique and would rather have a reversible filler. Some docs would rather have patients come back every 9-12 months and get reinjected. It's not for everyone, but I'm very comfortable with the safety of Bellafill and have 8 syringes in my face.

This is a great question. Many
physicians are unwilling to inject Bellafill because it is relatively permanent. Some feel that they will make a mistake with
it and have more comfort with the short term products that are more
forgiving.

Some physicians are worried about the supposed complications like lumps and
bumps. However, if they did their
research, they would find out that Bellafill is mostly injectable collagen in
the beginning and injectable collagen almost always made some lumps. These virtually all went away as the collagen
resorbed over the 3 to 6 months after an injection, just like the lumps form
Bellafill if they occur.

Finally, many physicians are worried that you will not come back to see
them because Bellafill is so long acting. In other words, they see the short term fillers as better revenue
producers.T his is unfortunate as there
is a place for all of the products that we have at our disposal. For you, the consumer, your job is to locate
the experienced physician who has all of the tools and knows how to correctly
apply them to your situation or problem to achieve your goals.

I hope that helps.

Best regards.