I am certainly so sorry you are having this problem. Permanent fillers, like aquamid, silicone and even Bellafill pose the potential risk of giving rise to very difficult-to-treat complications, such as nodules and granulomas (as in this case), which may begin soon after treatment or anywhere from five, ten to even twenty years later, as is apparently happening here. As you no doubt know, Aquamid is a permanent filler, which like silicone, was never approved by the FDA for aesthetic uses. Although it was not permisible in the U.S., it was available in my Israel satellite facility, where I chose never to use it. I also choose not to use Bellafill despite its recent approval for the same reasons mentioned. While it is certainly enticing to desire a permanent filler, so thatthe job is done once and for all, I do not use any permanent filler, since any problems or complications are also permanent. Unlike natural, hyaluronic acid-based fillers, there is no enzyme to dissolve alcamid (or silicon or Bellafill, for that matter), Surgery to remove the granulomas can leave disfiguring scars, since these materials typically intercalate themselves into the normal surrounding tissue following injection. I have had some measure of success in shrinking permanent filler granulomas using anti-inflammatory injections such as triamcinolone and 5-FU, sometimes accompanied by physically breaking up the nodules with saline injections and subcision. Make sure that you consult with a board certified aesthetic physician. Best of luck, and once again I am sorry you are having this difficulty.
