Can I get Bellafill injections in acne scars previously treated by silicone?

Bellafill and Artefill are known to cause granulomas. Although used for soft tissue augmentation, they can, and are known to cause permanent nodules and swelling. This is not the case for everyone. 
My office specializes in the removal of Bellafill and Artefill injections, in addition to silicone biopolymers, from the face and body. Initially, treatments are non-surgical with corticosteroids and immune modulators. If unable to be corrected, we can also perform surgery in some cases. 
Lastly, our office is conducting ongoing studies of plasma-assisted corticosteroid application, which allows for diffusion of the treatment medication in superficial tissue without causing atrophy. 
Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Thank you for sharing your excellent question. Theoretically you could add Bellafil to the previously treated silicone areas but I tend to avoid doing so due to the issues that can accompany silicone - hyper/hypopigmentation, lumps, bumps, contour irregularities. You may wish to consider TCA cross, micro needling and other topical skin options to improve the scars' appearance.

Silicon is very unpredictable and can form a very aggressive inflammatory response even after 10-15 years. Any type of injection in the face, even if not even close to the original area can elicit this problem. In addition to injections, laser, microneedling, and RF can do this as well. It is hard to advise you to the best treatment because almost anything recommended has the potential to cause the silicon reaction. Once this problem occurs, it is extremely difficult to control. Silicon tends to spread, probably more than any other filler. This has been noted with recent advances in facial ultrasound. In general, boxcar scars are not treated best with filler but rather with TCA Cross, laser, and RFM.