Can Bellafill in tear troughs be removed or altered? (photos)

Question

I had Bellafill placed with a cannula about 3-4 weeks ago. I now see a lump under each eye, more so under one eye. The filler was placed in the tear troughs. What are my options at this point? I want to know if the Bellafill can be removed or altered.

Jason Emer, MD · Answer

Bellafill is best placed elsewhere and in small depot injections.  I suggest 5fu/steroid injections and venus legacy/viva treatments. Please see an expert who treats a significant amount of filler complications.  Best, Dr. Emer.

Ravi Dahiya, MD · Answer

I would not try to do anything this early on in your treatment. Swelling can persist for quite a while when fillers are used in the tear trough. So things are most likely to still get better. I would be sure to follow up with your doctor as there are some options should this not continue to improve. Any treatment or procedure can have some potential for corrections or touch ups but the good news is that things can almost always be made better.

Mary P. Lupo, MD · Answer

Bellafil is often called "permanent" I have seen delayed nodules from over injection for volumizing the jowl area and tear trough. Unfortunately this cannot be reversed. if it is granulomas, IL FU might help, but many of these deformities are indeed permanent. Bellafil may have a place for acne scars where the technique is different and the volumes are smaller. In my opinion such bio-stimulatory fillers are NOT appropriate in the tear trough.

Steven F. Weiner, MD · Answer

The final effect from the injection takes months to see. This is still way too early to be disappointed. Sometimes steroids orally can be given if this is felt to represent inflammation. If this is a granuloma, F5U and Kenalog might be needed. Lastly, surgery can remove any long-term visible nodules.

Kyle T. Yamamoto, MD · Answer

Bellafill is considered a permanent filler and made up of polymethylmethacrylate (PMMA) and bovine collagen.  Unfortunately, injection of hyaluronidase, which can be used with other fillers, is not effective in dissolving Bellafill.  Currently, no injectable products exist to remove or alter Bellafill.In my opinion, the best option in removal of Bellafill is surgical excision.  I would recommend you contact a surgeon in your area who is an expert in lower eyelid surgery.  A good surgeon can evaluate you and decide with you if you're a good candidate to have the Bellafill removed.Another option is to leave the Bellafill where it is.  Since the injection was only 3-4 weeks ago, you may experience some more change and settling of the product over several more weeks.

Brian Windle, MD (retired) · Answer

Bellafill is a wonderful solution for the tear troughs but
it can result in unwanted outcomes if it is not placed exactly right and with
the right technique.  Problems can occur
even with the right technique.

All fillers can cause some lumps and bumps in the first few
days and these can last a few months. If your filler was done more than 3
months ago and you still have some lumps that you can see then an injection of
a crystal steroid call Kenalog 10 will usually settle these down.

There are a number of reasons for lumps or lower eyelid
bags, while very unusual after a Bellafill injection, do occur and could be the
result of a number of different problems including chronic swelling due to the
injury (festoons), exacerbation of chronic underlying allergies, the Bellafill
creating the bags, and a coincidental dermatitis causing chronic swelling.  It is always best to see an experienced
injector and be evaluated to find out exactly what the problem is.

Bellafill can be removed surgically but in 9 years of
injecting it, I have yet to see a case where this is required.I have added a video that talks about fillers and a web reference for you.I hope that helps.

Best regards.

Can Bellafill in tear troughs be removed or altered? (photos)

Answers (6)

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