Is there any risk that comes along with getting Bellafill in the cheekbones?

Question

Hi doctors, Can you tell me if there are risk with Bellafill, which is a filler that last in the face for about 5 years? It's suppose to be similar to other fillers but longer lasting. Is there any danger or risk with this type of filler?

Raffy Karamanoukian, MD, FACS · Answer

Bellafill filler can cause nodules and chronic edema, soft tissue reaction, and longterm problems. We specialize in the removal of Bellafill on the face and see patients with old and new PMMA filler problems. Bellafill will eventually form scar tissue around the permanent filler. We recommend a combination approach of filler reversal with enzymes, corticosteroids, and scar tissue modulators. Our HIDEF approach can break down filler scarring and granulomas so that they are less apparent. If the filler material itself does not dissolve, it either means the filler is unresponsive to conservative therapy. This technique may be followed by surgical removal of the filler if there is a suitable target for removal and the chance of scarring is low. We remove Bellafill filler from the lips, nasolabial folds, and eyelids. Cheek Bellafill is difficult to remove surgically.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  There is no additional risk with Bellafill compared to other fillers except for the fact that it can not be dissolved like the hyaluronic acid products like Restylane, Belotero, or Juvederm.  If placed by an experienced injector this should not cause any issue.  Hope this helps.

John L. Burns Jr., MD · Answer

No filler comes completely without risk.  Bellafill is also different because of its longevity.  However, for the cheekbone area, the filler is injected deeply with minimal risk.

Michele Zormeier, MD · Answer

Thank you for your question. 
Bellafill contains PMMA microspheres which provide a scaffold that supports your own natural collagen production as it develops over time.  Bellafill replaces lost volume.  More than one treatment may be needed, but results are excellent and long lasting. It is a great choice for cheek augmentation. 
There are risks of granuloma, vascular complications and blindness but these are less than 0.05%;  So extremely rare and can happen with any filler   
This filler should be injected by only an experienced injector and preferably a physician.  
Please consult a local board certified facial plastic surgeon for more information and a comprehensive consultation

Steven F. Weiner, MD · Answer

Bellafill is a great choice for cheek augmentation if injected by an experienced physician. It can lead to complications as can any filler if not done properly. Lumps, nodules, infection, and granulomas are possible. Vascular complications and blindness can occur but are extremely rare. I use cannulas to diminish the risks when injecting Bellafill. There is a 5 year safety study that shows low rates of complications with Bellafill - about a 1% granuloma rate.

Ravi Dahiya, MD · Answer

Bellafill is a wonderful filler for around the cheekbones. In fact this is one of the areas in which I think it provides the best results because it creates the effect of a "midface lift". Also this part of the face can require several syringes of whichever filler you use so it makes sense to use something that lasts as long as Bellafill. I would say that this is the one filler you should be absolutely sure to have an experienced provider. Whereas other fillers can be broken down and go away relatively quickly this one really does last. So it is imperative to have someone who has the experience to get it right and understands how it is best used.

James Fernau, MD, FACS - Account Suspended · Answer

Thank you for your question.  It is very important that you seek a board certified plastic surgeon who has expert training with this specific filler.  They must be knowledgeable in the anatomy of the face.  With this being said,  Bellafill is a long term filler giving predictable results when injected with precision and discipline.  I identify the anatomy of the blood vessels with the AccuVein device.  This is extremely important in the periorbital area and the nasal region.    In these areas, I often use a sterile blunt cannula and retrograde injection technique to avoid injecting into vessels.  Augmenting the cheeks is relatively easy by placing Bellafill deep using the syringe needle technique.  Often overlooked, a very simple principle for patients and surgeons to follow is a facial decontamination protocol before injection.  We have our patients remove all makeup and sterilize the face with Baby Phisoderm and generous alcohol wipe preparation just prior to injection to avoid infection and granulomas.Best wishes in your endeavors. Sincerely,
  
James Fernau, MD, FACS
  
Board Certified ENT
  
Board Certified Plastic Surgery
  
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science