I have large hard lumps inside my bottom lip. What are my options? (Photo)

The development of large, hard lumps under your bottom lip after Bellafill injections is a matter that should be addressed with your healthcare provider or the professional who administered the treatment. These lumps could be a reaction or complication related to the filler. It's essential to consult with them for an evaluation to determine the cause and discuss potential solutions or corrective measures.

There are several types of fillers that can react similarly to Bellafill and these include Artefill, Artecoll, PMMA. The filler polymethyl methacrylate contains microspheres that can contain varied amounts of collagen and are used to fill volume into soft tissue and skin. According to the manufacturers of Bellafill, the "collagen gel in Bellafill® provides immediate volume and lift to correct wrinkles and acne scars. Once injected, these microspheres stay in place and create a base that provides structural support for smoother-looking skin." Although this is true, it may also cause reactions in a small subset of patients.

Bellafill contains polymethylmethacrylate (PMMA) microspheres that are used for soft-tissue augmentation. Bellafill injections are usually placed superficially in the lips, cheeks, chin, and jawline and can sometimes cause severe, long-term complications including filler migration, granuloma formation, nodules, swelling, edema, and uneven contour. These are common side-effects of Bellafill. If you have had Bellafill PMMA microspheres injected into your lips or face, you may require plastic surgery treatment by a board-certified specialist.


If you are looking for a treatment option for PMMA in the lips or face, there are two main treatment options available in our center. Although surgical removal of Bellafill and PMMA is a common method of repair, it often requires placement of incisions directly above the nodules in the face. Surgical excision of PMMA is a good option when the incisions can be hidden in barely noticeable areas of the face. Diffuse concentrations of PMMA Bellafill are unlikely to resolve with surgical excision, and thus the second option involves intralesional injections to reduce the fibrosis and scar tissue around the PMMA ,

Intralesional injections are a newer option for people who suffer from complications associated with Bellafill. This method is non-surgical and less invasive and is appropriate for patients who have diffuse concentrations of Bellafill in areas that are cosmetically-sensitive and less likely to improve with surgical excision. Intralesional injections allow our board-certified plastic surgeon to reduce the size and density of PMMA into smaller pieces that can be managed with less complications.

Surgical removal and intralesional injection removal of Bellafill can cause some side effects, such as mild, bruising and swelling; but these are usually transient effects that can be improved with time using laser technology.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Sorry that this has happened to you. I have been cautioning my regular followers for years not that the use of permanent fillers (and understandably the idea of a permanent solution is enticing) can result in difficult to treat or even permanent complications. This is precisely why I do not recommend them and even do not recommend the so-called semi-permanent fillers, such as Sculptra and Radiesse because adverse reactions to these are also very difficult to treat. By contrast, HA fillers, since they are natural products and not foreign substances (like silicone or Bellafill) can be easily dissolved, should the need ever arise, via injections of a natural enzyme hyaluronidase. That being said, I have had gratifying results treating patients who have come to me with complications of permanent fillers using an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. You would be wise to consult with a board certified cosmetic dermatologist with experience in treating filler complications. Hope this helps and best of luck.

The posted photo gives perfect example of risk of off label use of a semipermanent filler. Only excision can correct or improve. Expect fees in $2,000 ranges. Best to virtual consult with ….