Hard lumps from Bellafill. Searching a 2nd opinion before cutting to remove the lumps. I need to find a Bellafill qualified dr.

Bellafill is a collagen stimulating filler that has been highly popular because of its longevity.  Over production of collagen can occur but it is extremely rare though that probably doesn't help you in your case.  I have a high volume Bellafill practice but haven't seen the nodules.  Dr Castellano has done more than me and loves Bellafill.  Steroid injections work well to treat the lesions but can take a few months to resolve.  Typically, these nodules can be felt but aren't seen.  If that's the case, give them some time and they will dissipate themselves. 

Complications from Bellafill and Artefill are quite common and our office specializes in the removal of these fillers, if possible. Best, Dr. KaramanoukianLos Angeles

Bellafill, in it's previous life was known as Artefill and in Europe/ Canada for years as Artecoll.  The permanent component of Bellafill is polymethylmethacrylate (PMMA) which the body cannot absorb, nor can it be dissolved.  This is one of the major concerns that some of us have about this product.  The face ages, but the PMMA does not and can cause issues years down the road. These "lumps" may be related to a sensitivity to bovine collagen or to the PMMA. If you continue to have these areas of inflammation, your Doctor is correct that surgical removal may be indicated. 

Bellafill is roughly 80% collagen which disappears quickly and 20% PMMA. The PMMA cannot be dissolved and if a problem has only two options. One is to surgically remove it. the other is to camouflage by injecting a hyaluroric acid based filler (Resylane or Juvederm brand) or fat grafting over it.. See a doctor who does a lot of filler injections.

Bellafill is a remarkable, long-lasting filler with an extremely low complication rate. In the rare event of a complication, it is best to follow the advice of your injecting physician.  Dr Castellano is one of the most, if not the most, experienced Bellfill injectors in the United States.  Also, the skin test is simply the bovine collagen part of Bellafill and it is meant to test the patient for allergy to the bovine collagen.  That part of the product is eliminated in 6-12 weeks.  Therefore, the bovine collagen part is completely gone by 5 months.  The test would not have predicted or prevented your complication/"lumps".

Bellafill is a  bovine collagen based filler which contains polymethylmethacrylate (PMMA). The product contains  also lidocaine which is a local anesthetic. It is imperative that skin testing be performed four weeks prior to injection. As with any filler granuloma , nodule or lump formation can occur. Bellafill is really meant for a subdermal injection and is contraindicated in thin skin such as the lips. Massaging the bump or nodule may help.  Most lumps from dermal fillers which are hyaluronic acid based can be easily treated with hyaluronidase injections, however, the issue is different with Bellafill. PMMA nodules have been shown to respond to intralesional corticosteroids. Systemic corticosteroids may offer some benefit as well. Allopurinol has also been shown to be of some benefit.  Most lumps will resolve with time. Surgery is the last resort.  The key to successful treatment with Bellafill is proper skin testing beforehand, aseptic technique injecting, and placement in a subdermal location.

Sorry for your issues But"BELLAFILL" is a semi permanent filler and there is NO injection to dissolve it! Only excision will help...///

Good Day. Thank you for your question.
Surgery is an option, however, it is the last option. It is unusual that this method of treatment is necessary. 
The goal of Bellafill injection is to treat the site of volume loss, but its prudent to inject about 80% of the estimated amount to treat the area. This method lowers the risk of over-injection. About 50-100% of the volume initially injected will remain long-term if not permanently. The average is about 80% of the initial volume injected persists.
The success rate of injecting either Kenalog (steroid) alone or in combination with 5-FU is 95-98% effective in reducing nodules (granulomas) or excess Bellafill injection. Serial injections may be needed so intervals of 3-5 weeks between injections is recommended. 
Skin testing is not necessary prior to aesthetic injection if you consume red meat and have not had any adverse reactions and that you have been treated with a local anesthetic without a reaction. In over 3000 over my patients, no adverse reactions have occurred. In Canada, its voluntary to perform a skin test prior to the aesthetic syringe being injected. The filler was approved in the US by the manufacturer recommending a skin test itself. The FDA followed their recommendation. However, with the poor sensitivity of the skin test and the rare risk of reaction, Suneva Medical will soon submit to the FDA for no skin test be needed.
In summary, Injection of Kenalog with 5-FU will most likely absorb some of the collagen synthesized by your body to lessen the excess volume appearance.

I am sorry to hear that you are having this problem. I regularly see and deal with problems from
Bellafill form around the country. I
have used Bellafill since it first was available. It is a great filler or volume replacement in
the right hands.



Bellafill is composed primarily of collagen and collagen
will almost always make lumps that go away completely, in time. Lumps or bumps were a common complaint of
patients who used to get collagen injections.
The good news is that they all go away if you are patient enough. The 5 year study on Bellafill was just
reviewed and approved by the FDA. This
showed that any lumps or bumps that occurred with this filler were almost all
gone by a year and that 12 out of over 1000 patients who were followed and had
a lumps at a year did not have those lumps at 5 years.



Many physicians are worried about the PMMA particle but
these only make up a total of 0.1cc in each syringe, are negatively charged so
they will not clump and are all 40 microns in size (about the size of a single
cell). All of the lumps that have been examined
pathologically have shown that they are simply scar. Scars usually will respond to an injection of
a steroid called Kenalog that often needs to be repeated on monthly intervals
until the scars softens and settles in volume.



The first question I would ask is are you lumps visible? If they are not then I encourage you to be
patient. If they are then I would
encourage you to seek a second opinion by someone who has extensive experience
with this product. Check the Suneva Medical
website for providers of Bellafill in your area and then check their
credentials with respect to Bellafill.



I hope that helps.



Best regards.