Bellafiill vs. fat transfer to face which will last longer?

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

Bellafill becomes collagen very quickly and isn't "in your skin" after a short time period but stimulates your own collagen production. Both Bellafill and fat transfer would be permanent options. Keep in mind, fat transfer technique is important for successful fat transfer. I recommend water-assisted fat harvesting which gives pure fat to transfer and combine with platelet rich plasma (PRP) to get the most viable and sustainable fat cells. I combine with Sculptra (depending on area) to improve results. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Fat Transfer is a great option whereby you are using your own fat. There are no guarantees how each person will retain the fat graft. There is down time with Fat transfer where Bellafill is an in office procedure that gives instant results. If you want correction and do not want to do a minimally invasive procedure with some down time Bellafill is a great option.

Great question. I would recommend Bellafill as it lasts 5 years or longer depending on the patient. Bellafill is a collagen based filler that stimulates your own collagen so once the Bellafill has been processed by the body, the treated area still looks better than before these injections. Fat transfers are great however not all of the fat injected stays in the desired area, over time your body will naturally process and remove it. Fat transfer to the face is unpredictable as we are not sure how much fat will remain within the next few months.

This is a great question. Bellafill is composed of PMMA particles which stimulate collagen. The PMMA is not degradable by the body so the results are long lasting, probably permanent. Fat transfer requires a liposuction to remove fat and then the injections. The take of the fat is variable so it is common to have more than one procedure to get optimal results. The injections of the fat require larger cannulas/needles than does Bellafill because the fat will be harmed by the smaller instruments. Viability of the grafts has improved when using microfat and nanofat with PRP (high concentration) techniques. This is because the fat globules/aggregates are smaller and the ingrowth of new vasculature is better when the surface area to volume ratio is higher. The inner aspects of larger fat aggregates die because the vascularity isn't established soon enough. This is one of the many factors that account for poor take of a fat grafts. Other variables of excessive manipulation, possibly air exposure, and poor technique. In general, Bellafill is more reliable, and more precise than fat grafting. Cost will probably be less in the long run with fat grafting, but there will be more downtime with the fat grafting as well.

Hello! Both would be permanent options. 
Bellafill  is used to smooth moderate to severe facial folds and wrinkles from the nose to the corners of the mouth. Bellafill is meant to be a permanent wrinkle solution as well as restores volume and fullness to the skin. Bellafill is composed of nonabsorbable microsphere collagen which acts to provide support for a longer-lasting wrinkle correction. Most patients see results within one or two treatments  Remember Bellafill is a non-resorbable dermal filler, unlike many other dermal fillers that are absorbed and require reinjection so again results are permanent and surgical removal of the collagen is required for reversal of effects.
Keep that in mind and I recommend a consult with an experienced provider!