Belafill injections about a year old. Suddenly, the injection sites have become hard and even. Seem to have moved. (photos)

Question

Has something happened to where my body Is now rejecting the product? What can be done?

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

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. The several side effects associated with the use of Bellafill are rare and may include pain/soreness but will not occur a year after the procedure. I suggest that you consult in person with your board certified facial plastic surgeon to determine the cause of your experience.

Best wishes,

Best wishes,

Jason Emer, MD · Answer

This is not a normal outcome. 5fu/steroid injections and venus legacy or exilis treatments may even out the results. Please see a physician to be evaluated and treated. Best, Dr. Emer

Jill Foster, MD · Answer

Based on the history you provided, I think this IS likely to be a reaction to your filler injection and you should consult the physician who injected the Bellafil.   If it is not a condition they feel comfortable evaluating and treating, ask them to refer you to a physician to help you manage and treat the problem.   There are true biopsy proven granulomatous reactions ( firm lumps like you have described)  to injected materials, and this can occur long after the material is injected.  Infectious agents, particularly atypical mycobacteria, could also cause what your photo is showing, and your doctor will likely want to do both tissue cultures and biopsies.  Autoimmune skin disorders could also cause these skin changes and things like sarcoidosis and discoid lupus are also in the differential diagnosis.  The skin biopsy and some blood tests would help to give the doctor information about the autoimmune disorders.

Steven F. Weiner, MD · Answer

You need an evaluation by your injecting physician. This is hard to see in the pictures. This can represent a granuloma, nodule, or infection. These are treated differently so physical exam and history will lead to the right diagnosis. Most likely, injection with 5FU with Kenalog is needed to take care of this.

Brian Windle, MD (retired) · Answer

I am sorry that you are experiencing this problem.  What it sounds like you are developing is delayed scar reaction to the Bellafill.  Many injectors will call this a granuloma but the pathology that I have seen in these cases suggests development of immature scar and as a result it is hard and firm, similar to a keloid scar under you skin.  You should see your injector.  This usually responds very well to repeated injections of a small dose of a combination of 5 FU an Kenalog 10.  I hope that helps.Best regards.

Belafill injections about a year old. Suddenly, the injection sites have become hard and even. Seem to have moved. (photos)

Answers (6)

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