Can Artefill migrate to your chin 11 years AFTER you got the injections? (Photos)

Question

I received Artefill injections in 2006 to the lips, nasal folds and forehead. These large lumps apprear on my chin almost overnight a few days ago. Could these possibly be granulomas after all these years?? Would you recommend I have a dermatologist or a plastic surgeon look at them??

Hung William Song, MD · Answer

After all these years, the PMMA particles would have integrated into the local tissue and the injected collagen would be long gone. I have been injecting Artefill (now Bellafill) for about 7 years and, I have not seen a reaction like this. I have only seen tiny nodules the that resolved after injection of a small amount of steroids into the nodule. I agree that you should first see the physician who injected it since they would know exactly how much and where the injections were made. Or, see someone who is familiar with type of cosmetic filler. I once had a patient who complained of severe pain in her face a month after fillers. She went to her primary physician who blamed it on the fillers and sent her to the ER. The ER doctor said it was definitely from the fillers and sent her to an ENT. The ENT  had the presence of mind to order a CT scan which showed an obvious case of sinusitis and she responded nicely to antibiotics. If she would have come to me first, I would have told her this was unlikely to be related to her fillers and could have saved her a lot of running around and headache. I'm not saying that it is impossible that it is related to the Artefill, just be careful that the doctors treating you are not prejudiced by the fact that you had a cosmetic treatment years ago.

Jason Emer, MD · Answer

It's difficult to tell from your pictures. I recommend getting a formal evaluation with a cosmetic dermatologist. 5fu/steroid injections and venus legacy/viva treatments can help give improvement. See an expert. Best, Dr. Emer

Richard E. Moore, MD · Answer

Thank you for your question and posting your photos. Three things initially come to mind - 11 years and development of nodules nearly overnight, in a site remote from the initial injections. I have seen delayed reactions to Artefill 3 years out but not 11 years out. Still, I imagine it is possible. They tend to develop over time rather than suddenly. The remote location relative to your injection sites is also a part of the puzzle. I would recommend following up with either your injector or someone very experienced with Artefill/Bellafill. This should be reported to Suneva to get their advice on how to move forward. Most likely, they will recommend a biopsy to determine if PMMA is present in the nodule. If so, the first line of treatment is Kenalog/5FU injections. On a side note, I don't believe Suneva was the distributor of Artefill at the time of your injections but they should be helpful since they do not want the product to get a poor reputation.
I hope this was helpful - Dr. Moore.

Jared Troy, MD · Answer

Artefill should not migrate to any appreciable extent. If this is related to your prior injection (and not an underlying tooth/jaw problem), then it is possible to have a late reaction like this. You should seek consultation with the provider that placed the filler, as steroids/5-FU injections can calm it down.

Steven F. Weiner, MD · Answer

I would seek out the opinion of a Dermatologist or Plastic Surgeon who currently uses Bellafill. I can't tell by the pictures if this is related or not to the prior injections. Do you have an infection in the mouth which could have caused this?

Elysa Fisher, MD · Answer

Thank you for your question.  Bellafill stimulates the formation of collagen that integrates into your tissue in a natural way.  It is very unlikely that any new dramatic change is due to product injected 11 years ago.  I agree that seeing your plastic surgeon or dermatologist is a good next step to evaluate these new growths.

Robert J. Troell, MD, FACS - Account Suspended · Answer

Good day. Thank you for your question and photographs.Artefill (Bellafill) was NOT available in the USA until 2007. When it was first FDA approved, no one was injecting it into the vermilion border.I must assume you were injected with liquid silicone (Silikon). This substance can migrate and form this type of soft tissue reaction, even this long after the injection.Bellafill has inert methylmethaculate that stimulates human collagen synthesis. This collagen interlaces with your adjacent tissue within 2-3 months, making migration nearly impossible after this period of time.I recommend acquiring your medical records and contacting the previous injector. A physical examination by an experienced surgeon or deciding to perform a small biopsy to confirm the diagnosis may be indicated.Kenalog injection can be attempted, since it will treat both etiologies of the reaction.

Alexis Parker, MD - Account Suspended · Answer

I recommend that you first see the doctor who injected you if possible, followed by a doctor with experience treating these late appearing nodules. Medications would be the first line of treatment, including antibiotics and possibly steroids.  Many products injected into the face can cause problems at a later date, which is why it is important to go to an expert injector who uses the most sterile and safe techniques and knows how to treat complications that may appear at a later date.  Please see someone as soon as possible.

Can Artefill migrate to your chin 11 years AFTER you got the injections? (Photos)

Answers (8)

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