Infection after Bellafill. Akin abscess turned into a biofilm infection. PIC line placed.. No improvement...help please! (Photo)

Question

Bellafill injected on 5/4..skin abscess appeared on 5/14. Oral antibiotics started on 5/16. Drainage completed on 5/29. Kenalog injected on 6/7. Referred to ID doctor on 6/15. PIC line placed on 6/17. Daptomycin and Ertapenem Sodium started via pic line. Orginal drainage site continues to drain large amounts of infection. 6/25 redness and swelling moved to lower eye lid area. Ultrasound showed cellulitis in entire area. the infection is not localized to the original area and spreading.

Jason Emer, MD · Answer

Continue to follow up with your primary care physician (or see an infectious disease doctor) for treatment of cellulitis and continued antibiotic therapy. Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

Filler migration and granuloma formation can cause longterm problems with Bellafill and Artefill fillers. This is similar in patients who have Artecoll and PMMA fillers. Longterm filler complications include migration, edema, chronic swelling, and nodularity. If patients have filler migration or nodules, 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 likely not HA material or 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.

Surgical removal of Bellafill is possible and we have a wide ranging experience with the treatment. Some areas of the face can be treated because the Bellafill removal scars are barely visible. We have found that Bellafill nodules, if palpated, can be removed from the tissue. Undereye Bellafill, nasolabial fold Bellafill, and lip filler can be treated successfully. Diffuse Bellafill is difficult to treat.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Surgical removal of Bellafill is possible and we have a wide ranging experience with the treatment. Some areas of the face can be treated because the Bellafill removal scars are barely visible. We have found that Bellafill nodules, if palpated, can be removed from the tissue. Undereye Bellafill, nasolabial fold Bellafill, and lip filler can be treated successfully. Diffuse Bellafill is difficult to treat.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Lisa Vuich, MD · Answer

Facial infection after filler is rare but certainly happens and I am so sorry you are going through this! Be sure to have a plastic surgeon involved as well if you don't already, they may need to intervene here.Lisa Vuich, MDAddendum- Speak with your providers about further imaging such as CAT Scan or MRI.

Brian Windle, MD (retired) · Answer

I am very sorry to hear that you are going through this.  An infection after any filler injection is extremely rare.  Hopefully you have had a complete culture profile done.  There is a possibility that the injection and that infection are coincidental but it really does not matter.  The treatment would be same.  Usually, infections of this magnitude that do not respond to oral antibiotics take a few weeks to resolve as long as you are being given the right drugs.  Best of luck

Infection after Bellafill. Akin abscess turned into a biofilm infection. PIC line placed.. No improvement...help please! (Photo)

Answers (4)