Can a facelift be done safely in the future after having Bellafill?

Question

Hello. I'm 48 and 4 years ago had Bellafill. I was clueless then about the filler and am now concerned I won't ever be able to get a facelift in the future. 3 years in my nasolabial folds I had granulomas that were surgically removed. Come to find out, I had 9 injections, yes, in my nasolabial folds, upper lip, chin and jawline. Which i was trusting the injector and should have never had filler in the first place. My fault there. With that amount of Bellafill, is is possible to safely tet a facelift in the future? And if so, would the filler continue to change the outcome of the facelift? trying not to be depressed by the ever changing filler in my skin. Thank you for any helpfull advice. Katie

Semih Yildiz, MD, FEBOPRAS · Answer

In my experience, prior Bellafill and surgically treated granulomas do not necessarily prevent a future facelift, but they make planning more individualized. Because Bellafill is long-lasting, residual product, scar tissue, inflammation, or recurrent nodules could affect dissection and contour; facelift surgery is not designed to remove all filler or predict later inflammatory changes. Before scheduling, see a board-certified facial plastic surgeon or plastic surgeon who can review the injection map, operative and pathology records, examine the tissue, and decide whether imaging or treatment of active inflammation is needed. If there is active inflammation, defer elective surgery until it is evaluated. Ask how the prior granulomas change the plan and whether staged treatment is safer.

C. Carson Huynh, MD, DMD, FACS · Answer

Hello. Prior Bellafill does not mean you can never have a facelift, but it does make the surgery more complex. Permanent filler in the folds, lip, chin, and jawline sits in the planes we dissect, and the granulomas you already had treated show this tissue can react. A deep plane facelift can still be done by a surgeon who plans for that filler. Residual product can affect how the skin redrapes, so I would want an in-person exam and, if possible, records of where the Bellafill was placed.

Rudolph J. Triana, Jr., MD, FACS · Answer

Hi, Bellafill is a “semi-permanent filler” composed of 80% bovine collagen and 20% poly(methyl methacrylate) (PMMA) microspheres. This may cause permanent changes in the soft tissue, chronic inflammation (granulomas), and the potential for scarring. It is difficult to ascertain the level of scarring beyond a physical exam. A facelift could be performed, however, results may vary depending on the soft tissue changes in response to the product.

Stephen Prendiville, MD · Answer

Thank you for your question.  The simple answer is that you can have a facelift, by experienced hands, but it will likely be more complicated due to the Bellafill history. Bellafill is partially composed of polymethylmethacrylate, or the same agent found in superglue, albeit is much more refined particles.  Since the body recognizes it as foreign and cannot phagocytize the particles, granulomas can occur after injection. I have performed many facelifts after silicone injections and/or bellafill and a lot depends on how and where the product was injected. Good luck!

Serdar Bora Bayraktaroglu, MD · Answer

Yes, you can safely get a facelift in the future, but a history of Bellafill and granulomas requires an expert surgeon.Bellafill is permanent and causes deep tissue fibrosis, making tissue planes rigid and sticky rather than smooth and mobile. While it won't shift over time, it creates localized stiffness that alters how skin and muscles lift and drape.Consult a Specialist: Seek out an elite facial plastic or revision surgeon experienced in navigating heavy filler and scar tissue.Be Transparent: Disclose your exact injection history.With proper technique, a skilled surgeon can successfully perform your facelift.

Joseph A. Kelling, MD · Answer

As you know, Bellafill is a filler that isn't fully degraded by the body's natural processes, which can lead to the granulomas or persistent changes you've continued to notice. None of the current fillers are ever completely eliminated by the body &mdash; some are simply better tolerated than others, which is why physicians and injectors have to be especially careful with placement given those long-term effects.
That said, a facelift or neck lift is still very much an option for you. The main consideration is that prior filler placement can make the surgical dissection slightly more difficult, since the tissue planes may be more scarred together. This raises the risk profile only slightly &mdash; not enough to outweigh the cosmetic benefits of surgery, assuming you're otherwise a good candidate.
I hope this helps!

Michelle Zweifler, MD · Answer

In general, facelifts can be performed after fillers.

That being said Bellafill is a unique biostimulatory filler with creating one’s own collagen, may last 5 years and risks of granulomas, I would avoid surgery if inflamed or infected granuloma.  Overall, the areas of the nasolabial fold, upper lip and chin shouldn’t be affected during a facelift.

Just let the plastic surgeon know the history prior to proceeding with a facelift.

William Portuese, MD · Answer

It is certainly acceptable to undergo a facelift after Bellafil injections. We see fillers placed in the face frequently when performing facelift procedures. You shouldn't have any issues moving forward if you decide you wanna do a facelift. Choose your facelift surgeon very wisely based on extensive experience producing natural results.

Kyle Kimura, MD · Answer

Thank you for your question. 
First, I wouldn't beat yourself up about the decision to get filler. There is nothing wrong with that. Unfortunately, some people can experience complications such as yours that were unexpected. In general, filler in the face does not prevent you from having a facelift. It can, however, make certain aspects of the facelift more challenging (ie more scar tissue) and should be discussed thoroughly before your surgery. Ultimately your best option will be to schedule a consult with a plastic surgeon specializing in facial rejuvenation to talk about your unique anatomy and the nuances of surgery.
Hope this helps and best of luck,Kyle Kimura, MD

Zoran Potparic, MD · Answer

There is no doubt that filler of any kind, except properly placed fat grafts, would create some change in tissue anatomy, mostly related to consecutive scarring. This may be a potable when performing surgery (eyelids, face lift) and should be discussed with your surgeon ahead of time. I hope this helps.

Can a facelift be done safely in the future after having Bellafill?

Answers (13)

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