Bellafill injected 2 yrs ago. Cheeks look bulky. Can 5FU/steroids help?

Hi and thank you for your question! Steroid or 5FU can be used to reduce the size of Bellafill injection even after a few years, but before doing that, I recommend doing a complete reassessment of your face to make sure the bulkiness at cheeks is not due (or at least contributed in part by) volume loss at other places of your face. I hope it helps and good luck!

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

Yes,  5fu/steroid injections combined with venus legacy/viva treatments can help give improvement. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

I am sorry that you feel that your wonderful results have not lasted and that you feel your adverse effects were caused by the Bellafill injections. There are treatment options for you, but I am recommending you visit a reputable and experienced Bellafill dermatologist so that he/she can determine the right treatment for you.

Post a photo?
It is difficult to ascertain if you are having a treatment reaction. A sterile granuloma (body reacting to the product) is usually seen in  a more delayed fashion. Steroids and occasionally 5-FU can treat that inflammatory reaction, but they do "dissolve" the product.

I would try 5FU and Kenalog for this. If it weren't to work, you can consider collagenase. Otherwise surgical removal can be done. I see no point in doing venus legacy or viva treatments. Deep Ulthera treatments might have some benefits too by destroying the collagen or even PMMA spheres.

Good Day. Thank you for your question.5-FU and Kenalog are effective for both excess Bellafill injection and firm areas (granulomas).An examination to ascertain the cause is essential. Other etiologies should be ruled out. Rarely is surgical excision necessary.Your fullness increasing after three months is unusual. The body replaces 50-100%, usually 80% os the volume of the bovine collagen initially injected.Please undergo an examination by an experienced Bellafill injector to clarify the cause of the volume and the best treatment or you.

While photos of your concern would help to answer your question, the simple answer is that injections may help.  I have abandoned the 5FU protocol in favor of just using Kenalog 10.  Your physician should use small amounts and the injections need to be repeated monthly for 3 to 6 months.  Few Bellafill patients and most Bellafill injectors do not understand Bellafill.  Bellafill works so well because it stimulates your body to make scar in a controlled fashion.  In some patients, and especially patients who got a lot of bruising with their injections, the scar gets slightly out of control and makes more than we want or makes lumps.  The Kenalog injections are simply the age old scar management that we have used for years and I have found this works very well for the few instances that Bellafill creates a problem.I hope that helps.Best regards.