Has my filler traveled and spread? (Photo)

Question

Female, 37, 140 lbs, I have had lines under my eyes for years. I wonder if it was from getting Bellafill near my eyes? It seems to really show when I smile and when my toxins are strong and working great. Can you help me figure out what it is so I can get rid of it :)

Raffy Karamanoukian, MD, FACS · Answer

There are several types of fillers that can react similarly to Bellafill and these include Artefill, Artecoll, PMMA. The filler polymethyl methacrylate contains microspheres that can contain varied amounts of collagen and are used to fill volume into soft tissue and skin. According to the manufacturers of Bellafill, the "collagen gel in Bellafill® provides immediate volume and lift to correct wrinkles and acne scars. Once injected, these microspheres stay in place and create a base that provides structural support for smoother-looking skin." Although this is true, it may also cause reactions in a small subset of patients.

Bellafill contains polymethylmethacrylate (PMMA) microspheres that are used for soft-tissue augmentation. Bellafill injections are usually placed superficially in the lips, cheeks, chin, and jawline and can sometimes cause severe, long-term complications including filler migration, granuloma formation, nodules, swelling, edema, and uneven contour. These are common side-effects of Bellafill. If you have had Bellafill PMMA microspheres injected into your lips or face, you may require plastic surgery treatment by a board-certified specialist.

If you are looking for a treatment option for PMMA in the lips or face, there are two main treatment options available in our center. Although surgical removal of Bellafill and PMMA is a common method of repair, it often requires placement of incisions directly above the nodules in the face.  Surgical excision of PMMA is a good option when the incisions can be hidden in barely noticeable areas of the face. Diffuse concentrations of PMMA Bellafill are unlikely to resolve with surgical excision, and thus the second option involves intralesional injections to reduce the fibrosis and scar tissue around the PMMA ,
 
Intralesional injections are a newer option for people who suffer from complications associated with Bellafill. This method is non-surgical and less invasive and is appropriate for patients who have diffuse concentrations of Bellafill in areas that are cosmetically-sensitive and less likely to improve with surgical excision.  Intralesional injections allow our board-certified plastic surgeon to reduce the size and density of PMMA into smaller pieces that can be managed with less complications.
 
Surgical removal and intralesional injection removal of Bellafill can cause some side effects, such as mild, bruising and swelling; but these are usually transient effects that can be improved with time using laser technology.
 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

As a professional assistant, I advise that you consult directly with your dermatologist or a qualified medical professional for an accurate assessment. They can evaluate the photo and your medical history to determine if the filler has migrated or if there are other factors contributing to the appearance of lines under your eyes.

Bellafill is a long-lasting filler, and while migration is uncommon, it is not impossible. Factors such as the injection technique and the area treated can influence outcomes. If migration has occurred, your dermatologist can discuss potential treatment options with you, which might include adjustments with additional fillers or other cosmetic procedures.

To better assist you, consider scheduling an appointment with your dermatologist for a thorough examination and personalized advice.

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