What is the best type of imaging to differentiate Bellafill from scar tissue?

Question

I have scar tissue from an abcess I developed after I had my cheek implants removed and I have had bellafill in my nasolabial folds. I now have a lump in my left cheek where the abcess was. My surgeon said to go somewhere else. I asked if he could order a scan so I to tell if the lump is Bellafill or scar tissue and his office is ignoring me. I’m good to ask my pcp but not sure what kind of scan to ask her to order?

Anna Chacon, MD, FAAD · Answer

I’m really sorry to hear about what you’ve been experiencing—it sounds both frustrating and uncomfortable. When it comes to differentiating Bellafill from scar tissue, the most helpful imaging modality is usually a high-frequency ultrasound performed by someone familiar with facial fillers. Ultrasound can often visualize the filler material and distinguish it from fibrotic or scarred tissue.

In some cases, a MRI (magnetic resonance imaging) scan may also be considered, especially if the area is complex or deep, but it should be specified as a facial soft-tissue MRI to provide better detail.

When speaking with your primary care provider, you can mention that you’re looking for imaging to evaluate a lump in the cheek after prior Bellafill and abscess, and ask whether a soft-tissue ultrasound or MRI would be most accessible in your area.

I understand how discouraging it can feel when you’re not being heard by your surgeon’s office, but you’re doing the right thing by advocating for yourself.

What is the best type of imaging to differentiate Bellafill from scar tissue?

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