Bellafill left with lumps, bumps and uneven texture. Is a facelift the best option? (Photo)

Question

Bellafill used to treat acne scars left me with bumps,lumps, and jowlimg. It was injected to both sides of mouth. Is a facelift an option for removal amd tightening? What can be done here?

Nelson Lee Novick, MD · Answer

Unfortunately, this is an all-too-common compication from the use of permanent fillers. I certainly understand the allure of getting a supposedly one-and-done treatment with a permanent filler. But the reason I long-ago stopped using permanent fillers, like silicone and never started using Bellafil is quite simply that permanent fillers can translate into persistent or permanent problems, like disfiguring lumps and bumps, not just immediately after treatment, but even five, ten, or twenty+years later. And these complications can be difficult to treat, since there is no direct dissolving enzyme to shrink the problems, as there is with the use of natural, HA fillers. 
The problem with surgeries to deal with this problem is that surgeries (besides being expensive and engendering prolonged post-treatment downtimes) require cutting and cutting can itself translate into permanent scars.
Happily, I have been able to achieve gratifying results in treating the complications of permanent fillers (received elsewhere, of course) employing an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory injections. You would be wise to consult with a board certified cosmetic dermatologist with experience in treating this very troubling condition. Best of luck.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and the photos—they really help to understand what’s happening. From what you’re describing, it sounds like the Bellafill injections for acne scars unfortunately left some uneven texture, lumps, and possibly mild jowling, which can happen with permanent fillers if the placement or integration isn’t smooth.

A facelift could potentially help in a few ways: it can tighten sagging skin, lift jowls, and improve overall facial contour, but it won’t directly remove or dissolve the Bellafill. Because Bellafill contains permanent microspheres, you can’t dissolve it like hyaluronic acid fillers—surgical removal is technically possible but challenging and can be quite aggressive.

Other approaches to improve the bumps and uneven texture include:

Manual massage or remodeling (sometimes a skilled injector or dermatologist can smooth smaller lumps over time).

Laser resurfacing or microneedling with radiofrequency can help soften the skin and improve overall texture, but again, it won’t remove the filler itself.

In some cases, targeted surgical removal of small areas can be considered if the lumps are very localized.

So, a facelift could help with sagging and jowling, giving a lifted appearance, but it won’t fully address the bumps from Bellafill. Often, a combination approach—addressing texture first, then evaluating skin laxity—provides the most balanced improvement.

It’s understandably frustrating to have unwanted lumps from a permanent filler, but with careful planning, there are ways to improve both texture and contour even if full removal isn’t feasible.

Bellafill left with lumps, bumps and uneven texture. Is a facelift the best option? (Photo)

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