5 months post op, Bellafill injected near/on a nerve. What can be done to remove it?

Thank you for your question. With Bellafill being a “permanent” filler, it will require a number of strategies to ease the discomfort you’re experiencing. Oral medication to calm the nerve will help in alleviating the sensitivity, along with Acetominphen (Tylenol). A combination of energy treatments and specific injectable solutions may help to wear down the composition of the filler and lessen its volume in the area (potentially affecting nerves) or its longevity. I would seek out an injector who is experienced in dissolving and resolving filler-related complications. 

Bellafill is becoming increasing popular and is FDA approved for facial augmentation. Semi-permanent fillers such as Bellafill can cause granuloma formation. Removal of the granulomas is difficult in some areas of the face and easier in others. Treatment depends on the severity of the reaction and the amount of granuloma formation. 
Best, 
Dr. Karamanoukian

I have injected Bellafill for many years and use it quite regularly. I have never seen or heard of pain after fillers of any type. So this certainly represents a very rare situation. I agree with the idea that a MRI may help demonstrate if there is in fact any compression of the nerve by mass effect. There may be some other explanation for this especially considering it was only two syringes. 

I don't believe that the composition of the filler is the problem. It was where is was injected that is causing this. The infraorbital nerve has been injured and needs to be investigated. I would get an MRI and an evaluation from a neurologist. This should be treated as a trigeminal neuralgia. It might improve as the nerve recovers or it might not. Sometimes surgical decompression of the nerve helps, but that's not necessarily what is needed in this case. Consider tertiary care center evaluation.

Sorry to hear about your woes. This is impossible for us to give accurate steps apart from -1. Better pain relief. See a pain specialist. Pregabapentin can help, Cymbalta can help with nerve pain. Titrate based upon your specialist advice. Get an opinion from a neurologist. Exclude atypical trigeminal neuralgia etc....2. Image the area -sinus infection need to be excluded, exclude usual filler collections. It is your specialist who should initiate the investigations, exclude infection, the proceed as per peer reviewed methods to accelerate Bellafill metabolism. Not an easy thing to do because it is non - HA based. Approach your problem in a step by step manner. As always, I do not have problems with non - specialist injecting, but they have to know everything about filler complications and how to treat. All the best.