Is Bellafill best used before or after an Infini microneedling treatment?

Hi and thank you for your question! To minimize the possibility of RF microneedling interfering with the stimulatory effect of Bellafill, it's preferred to do it after microneedling not before it although I am not aware of any studies looking into this. It would also be best to allow the recommended healing time pass after the microneedling rather than following it quickly out of abundance of caution. I hope it helps and good luck! 

Hi and thanks for your question. I would recommend doing the Infini first, waiting a week or two and then doing Bellafill. Because Infini involves RF energy, there could be a concern about it affecting the Bellafill. Most likely it would be no problem, but these are expensive treatments so why take the chance? If you wanted to wait for 4 months or so after the Infini treatment, that would reveal the results of the Infini and you may need less Bellafill at that point. Hope that helps!

Thank you for you question, these can both be done on the same day and the fillers would be placed first. If you decide to do it on separate occasions it won't matter which is done first because Microneedling will not dissolve fillers, they are at two different skin levels. I hope this was helpful, see an expert. Best, Dr. Emer.

I do Bellafill the same day as Infini for the rolling acne scars. I skin test all patients prior to Bellafill, so the first session is Infini and skin test. The second treatment will include subcision with cannula if needed and then injection using a 23g cannula deeply and needle superficially. I treat the Infini as a sterile procedure so there is no concern regarding infection. The melting point of PMMA is 160C and Infini heats only to 65-70C. There is no need for the collagen in the Bellafill other than to act as a carrier for the PMMA spheres. There was a study by Dr Lim who showed the Infini does not affect HA or calcium hydroxyapatite fillers. I believe that acne scars much be treated with multiple modalities for best results. Volume loss must be replaced with fillers. 

Great question and one we've discussed at some length when we train other docs in out BellaDiamond office.  The answer we've come up with is a bit complex, so bear with me.
Bellafill is a two component system: about 6 million spheres of Poly Methy Methacrylate, suspended in a cow collagen gel, per syringe.  I agree with the other docs, that the melting point of PMMA is higher than the resurfacing energies being used, and it's basically inert.  
However, the cow collagen carrier gel can cook!, if its close to the 1-3mm depth that most microneedling devices drive down into the tissue.  Also, we treat Bellafill injections as a semi-surgical procedure since we are putting a long lasting IMPLANT into the tissue.  We keep the skin surface VERY clean/sterile before, during and after the procedure to prevent microfilm infection which are tough to diagnose and difficult to treat....
Because Bellafill is FDA approved for at least a 5 year duration of action, as some of the docs have mentioned, there's no reason to provide two great procedures at the same time.  Let your body absorb the cow collagen and then do the microneedling weeks later, or do the microneedling and let all the holes seal and inflammation go away before placing a material that may cause inflammation (cow collagen) into the superficial tissue-especially when we inject Bellafill into the dermal/epidermal junction to help correct acne scars.
Finally, If you are doing a series of RF microneedling, you may "shrink wrap" the skin enough over time to need a little less filler, but volume is still important in almost every facial aesthetic enhancement.
Hope that helps~  Z

Thank you for your question. It should make no difference whether you do the Bellafill the same day, before or after your Infini RF procedure. The PMMA particles are not effected by the Infini RF procedure. Due to Bellafill's long lasting nature, be sure to seek out the advice of an experienced injector.I hope this was helpful - Dr. Moore

Some doctors will do fillers such as Bellafill and microneedling on the same day and some prefer to do the microneedling series first, followed by Bellafill/fillers after. I would check to see your physician's preference (if any) and reasons. I usually do microneedling first to see what kind of response I will get, followed by Bellafill (especially if for acne scars).

Safe to do on the day. In most cases we do the fillers before INFINI- reason is that 1. we get a more accurate picture before swelling 2. Infini or RF does NOT break down filler. With Bellafill it is advised to get a test intradermal injection skin test 4- 8 weeks prior to the filler correction procedure. 

Acne scar revision comprises of many specialised procedures. For the best results, one should target the acne scar type with appropriate treatments METHODS. Using one or two devices is not optimal. As everyone has a unique pattern of acne scarring, the best solution is a tailored one. Remember, scar revision is a medical procedure that is technical to perform. It is not dependent on the clinic, branch, machine, or laser but by the skill of your dermatologist of plastic surgeon. 



Take for example deep ice pick scars, and narrow box car scars. These are best treated with TCA CROSS and focused angled Co2 fractional laser in low density. Deep narrow scars respond better to this treatment than even the most expensive lasers. On the flip side, rolling, and atrophic acne scars can improve with fractional devices such as Fraxel, fractional lasers, ProFractional erbium lasers, Infiini –Intensif –Intracel radiofrequency microneedling. Atrophic scars (depressions) can be treated with either fat graft, PRP or dermal fillers. Tethered and anchored scars are best treated with surgical techniques such as subcision. Other surgical techniques that I use include punch elevation, surgical elevation, punch excision and traditional excision for focal scars. Early and very mild acne scars respond well to eMatrix and non-energy microneedling, as well as vascular lasers. Skin colour changes such as PIH or dark marks respond best to sun protection, creams, and Q switch lasers in the nano and pico pulse durations. 



In the vast majority of patients, different patterns of acne scars will be present. Monomorphic acne scarring (scars of the safe subtype) are extremely rare. Careful examination, especially under angled lighting with scar mapping will give you an understanding of what are the best options for your scars. Additionally tactile examination namely touch will give me an understanding of the amount of subdermal fibrosis, as special equipment is needed for this sub-set of acne scars.  In the majority of patients its finding the correct combinations that yields the best results. It is never about the device, it is about the specialist behind the equipment that will deliver the best outcomes. 

Global leaders in acne scar revision will always use manual methods to revise scars, and employ lasers and energy devices as instruments to assist. All the best, Dr Davin Lim. Acne scar dermatologist specialist. Brisbane, Australia.