Bellafill for Acne Scars - Riviera Laser Studios, Dana Point, CA

I decided to purchase 3 more syringes of Bellafill for the acne scars on my cheeks, as well as book a laser procedure (both Erbium and MixTo fraxel, one after the other in the same appointment) to help with the appearance with my acne scars. I have some down time and I want to try to work on my acne scars as much as possible while I have the chance, especially before the summer months roll in.
I booked the laser procedure at Riviera Laser Studio in Dana Point, CA for 3/8/17, where I'm having my Bellafill work done. I enjoy Dr. Jeannine Kofford's approach and attention to detail, it's quite different from being a patient at Celibre or the facial plastic surgeon's office in Laguna Woods, where I had lasers for my acne scars done before.
I received prescription antibiotics and antivirals prior to the laser procedure. I will post a separate Review with updates for the laser procedure at a later time.
These two images below were taken on 3/5/17, 13 days after getting the last 3 Bellafill syringes injected into my cheek area, where the majority of my acne scars reside. *This makes a grand total of 8 Bellafill syringes I've purchased in three separate office visits at Riviera Laser Studio in Dana Point, CA.
I wanted to allow the product as much time as possible to settle in order to document the most realistic long term results.
As you can see, some of my older pictures looked "better," where my cheeks appeared flatter after only 5 syringes of Bellafill vs. how they look now after 8 syringes of Bellafill. This is due to my skin constantly changing. I feel like my skin changes constantly on a daily basis. One day it's dry and tight, making the scars on my cheeks appear flatter and less obvious, while the next day my skin is oily/combo, and my scars appear more prominent. One of the benefits to using topical Rx Clindamycin (antibiotic) and Retina A is that these products usually dry out my skin, causing it to peel while keeping my adult acne at bay. The benefit of having dry, tight and sometimes flaky skin is that the scars tend to look better on those days. I always try to hydrate as much as possible on the dry days, otherwise my system will start producing more sebum (oil) which can lead to more acne. It's a constant battle.
Thank you for reading, and remember to "shop around" if you're trying to improve your acne scars. Consults should be free, and I strongly recommend only a doctor (M.D., D.O.) that's a dermatologist or (facial) plastic surgeon to work on you. Gather different treatment plans from different places then take them home and compare/contrast them. Don't make any drastic decisions. For me at least, this is a process involving several procedures (lasers and Bellafill) spaced out over a period of time. I'm very happy being a patient of Dr. Kofford's at her laser clinic Riviera so I'm going to continue being a patient there.

Dr. Jeannine Kofford performed my acne scar reduction treatment using Bellafill over the course of two treatment sessions at her clinic, Riviera Laser Studios in Dana Point, CA and I couldn't be happier with my results! Dr. Jeannine is a laser and skin guru, with an "eagle eye" for perfection and natural looking aesthetics-so much that she's won many prestigious awards and even trains other physicians from all over the country. In the past I've had other lasers (Fraxel, Erbium) done as well as other doctors injecting my scars with fillers (Restalyn) but being under Dr. Kofford's care has BY FAR given me the best results.
1st Bellafill Treatment - 3 syringes
My first treatment session was performed on 7/1/16. Dr. Jeannine was conducting a training session with other observing physicians present so I was able to get a discount on my Bellafill. It was a very intimate setting with only a few other physicians present, so I wasn't intimidated. Only Dr. Jeannine injected the Bellafill, the other M.Ds just observed. I was very comfortable during the procedure. She injected 3 syringes of Bellafil into my worst scars, which are located mainly on my cheek and jawline areas. Her expertise and bedside manner were amazing. She has a calm, comforting voice and she worked quickly and efficiently, explaining exactly what she was doing the whole time while placing correct amounts of Bellafill in each cheek to flatten and minimize the deepest pitted areas. Immediately afterwards her assistant Cher placed ice packs over the injection sites and topical arnica gel was applied to my face. The ice packs were switched out with fresh cold ones to help minimize swelling. On a scale of 1-10 the pain level was about a 4. (Getting your legs waxed was more painful than Bellafill injections at Riviera Laser).
Over the next several days my face was swollen and tender with moderate bruising. The swelling was a normal response, due to the acute trauma from a few dozen injection sites on each cheek, temple and jawline as well as the Bellafill product itself being placed under the skin. Due to all of the swelling after the procedure, my acne scars temporarily appeared to be gone and my face did look a little puffy and bloated, which is expected. I temporarily had what appeared to be "normal" skin, instead of being my regular "crater face" self. The bruising was in patches only, and it took roughly 2 to 3 weeks to fade, but it was manageable using concealer. As the swelling and tenderness subsided over a week's period, several of my scars/craters slowly began to reappear, which was disappointing but I figured that'd be the case. Overall the severity of my acne scars was reduced as the Bellafill settled.
2nd Bellafill Treatment - 2 syringes
During my followup treatment with Dr. Jeannine on 7/15/16 I decided to get two more syringes of Bellafill because I still wasn't happy with how apparent and prominent my acne scars appeared. I have what is considered to be "severe" acne scarring from adult cystic acne. Yes there was an improvement with the first Bellafill treatment but many of them did reappear after the swelling went down. Keep in mind I've undergone several laser procedures over the years with little to no avail which is why I really wanted to give Bellafill a fair try.
GETTING TWO MORE SYRINGES OF BELLAFILL WAS "THE GOLDEN TICKET!" Those last two syringes made a SIGNIFICANT difference in the appearance of my acne scars! My cheeks, jawline and even temples lay more flat and supple. Those last two syringes of Bellafill worked wonders, whereas the first three showed slight to moderate improvement. I believe this is due to the first 3 syringes acting as a foundation for the later 2 syringes to really smooth and fill the craters in. Again, Dr. Jeannine Kofford used her precision and years of expertise to go after the worst areas to leave a natural appearance by using her perfected subcision technique.
Getting Bellafill injected in phases seemed to be the magic trick. I know that most cosmetic injectables require this approach, and at least for me this is where I got maximum results. I'm very happy that I decided to purchase two additional syringes of Bellafill. The first 3 syringes settled, the swelling and bruising were gone and instead of throwing in the towel after some of the scars reappeared I went for it and purchased 2 more syringes. Those last two syringes made a HUGE difference in scar reduction.
If you suffer from severe acne scarring like I do (where it looks like someone threw battery acid on my cheeks) then be patient with yourself and don't be disappointed if you require additional treatment sessions and additional Bellafill syringes. I believe that by having two separate Bellafill therapy sessions spaced a few weeks apart made all the difference for me. By allowing all of the swelling and micro swelling to subside in between treatments, Dr. Kofford and her assistant Cher were able to pinpoint exactly where to place more product for maximum results. It is mid Feb 2017 as I write this. I wanted to make sure that my Bellafill "held up" for at least several months before posting this review since I've undergone several other acne scar reduction procedures in the past (see below) with unsatisfactory results.
All of these prior procedures induce temporary swelling and even micro swelling (which is slight swelling that can last for several months), which temporarily makes your skin plump and tight, stretching it out and making your scars appear to be gone. But they aren't really gone, they slowly start to reappear, the same way you scrub a stain out of your carpet and slowly but surely as the weeks/months roll by, the same stain starts to reappear again. This is the same situation I've encountered over and over while trying various acne scar reduction procedures. In the past after a laser peel, I'd go in for my follow ups (right afterwards and usually a week later) and of course it appeared the laser worked wonders, but it's really the swelling from the trauma of your skin being vaporized off by an ablative laser is what makes it look so smooth.
I CHALLENGE ANY AND ALL DERMATOLOGISTS, DOCTORS (MDs, DOs, PA-Cs, NP, etc.) AND PLASTIC SURGEONS TO DO A FOLLOW UP "AFTER" PHOTO AT LEAST *ONE YEAR* AFTER THE LASER PROCEDURE. It seems that all of the Before and After photos on these laser and plastic surgery websites show the "after" photo only a month or two after the laser was performed, while the micro swelling is still abundantly present. ONLY AFTER ALL OF THE SWELLING IS GONE (MINIMUM ONE YEAR LATER) IS WHEN AN "AFTER" PHOTO SHOULD BE PUBLISHED TO A WEBSITE.
Past (unsuccessful) Acne Scar Reduction Therapies
Over the course of 15 years I've struggled with various Acne Scar Reduction therapies that did little to nothing on my acne scars. I've spent well over $10k on lasers and injectibles with zero to very minimum results. Some of these physicians have categorized my acne scars as "ice pick" (the worst/deepest) while others have told me that they're "rolling" and/or "box car" type scars. Everyone claims to be an expert just like every office claims to have the best/latest/greatest equipment and lasers. I highly recommend you shop around and do your own research. Consults should be free and you should only consult with an actual Dr or nurse that will be performing your procedure.
I've been on the Rx drug Accutane 4x, starting since I was age 15. I refused to go on it anymore, knowing how potentially dangerous it can be especially since we don't know of any long term adverse side effects years down the road. Yes, Accutane worked wonders and cleared up my skin great, even drying it out (severely at times) but slowly but surely my acne would return. Accutane is supposed to be prescribed dependent on the patient's body weight. Around age 18 I was prescribed Accutane for the second time, but the Dr. who prescribed it wrote me a prescription for the 10mg capsules. Well, I should have been prescribed 20mg based on my weight. Since Accutane makes your acne worse at first, then clears it up, my acne got significantly worse and stayed that way for several months. Again, I was on the wrong does. I should have been on a higher dose. Because of this, I began to pick and pop my zits, which made them feel better and look better under makeup. Me picking my skin while on Accutane is what caused my severe acne scarring. Accutane labels have SO many warnings, ranging from birth defects to sunburn. NOWHERE does it warn about scarring from popping your pimples. I hope the investigational brochure (label) has been updated to include this. I had Kaiser Permanent insurance during this time and a regular family practitioner prescribed me the wrong does of Accutane at age 18. Since then, Kaiser has revised their policies and they now only allow Dermatologists to prescribe Accutane, not Family Practitioners and/or Internal Medicine Drs. THIS REALLY SCREWED ME OVER! Add to that the fact that I've inherited the severe cystic acne gene from BOTH sides of my family. My father had deep craters in his cheeks, and my Aunt (mom's younger sister) had permanent pits and craters all over her face from severe acne as well. As a reminder, scars are just evidence of trauma and infection. I've undergone other Rx therapies as well as Accutane: Retina A, topical Clindamycin Phospahate, oral antibiotics (which cause me to have raging yeast infections unless I take expensive probiotics while on them) as well as OTC products like Proactiv. I'm currently using Retin A and topical Clindamycin which helps me keep my adult acne under control.
*PROCEDURE HISTORY*
2002 - DERMABRASION - This was my first treatment to treat my acne scars. This was right before lasers were the mainstream treatment option, I believe Fraxel and Erbium were just barely FDA approved. Dermabrasion (not microdermabrasion) is the intense removal of the top layers of the skin whereas the Dr uses a hand-held diamond encrusted burr to manually remove your skin. There is more downtime, more pain, and not as much collagen stimulation as with a laser. Oozing and crusting were significant. To my delight, my scars appeared to be "gone" after the procedure but over time as the swelling subsided they returned to my horror :(
2004 - Restalyn - I had a dermatologist in Costa Mesa inject my cheeks with Restalyn. During this time, the only injectibles on the market were Restalyn and Botox. Nothing else was FDA approved yet. Topical numbing cream was applied and it hurt like hell. My armpits and bra were soaking wet afterwards from the pain. I should have been given a nerve block, but then again I was young and stupid, and I doubt the Derm was experienced using Restalyn, especially for acne scar treatment. From what I remember, the swelling and pain lasted for about a week, and the product itself began fading after 6 months, and was fully gone 9-10 months later. I could barely afford it and it's heartbreaking having improved looking skin only to have all of my craters reappear to haunt my diminished self esteem again. This is when I decided that temporary injections weren't for me. They definitely work as a quick fix if you have the disposable income, but when the product starts to break down and go away it's too depressing and even devastating. To me it's like "sweeping the dirt under the rug," and not really attacking the root cause of the problem. I needed something more permanent.
2007 - 2009 - ERBIUM LASER - I went to Celebre in Orange, CA and was talked into their Erbium Micro Laser Peels. At the time, they did not have a Fraxel laser despite having several lasers for various therapies. Prior to my first Erbium laser at Celibre, I undergone a different non-ablative laser there for one year to "permanently" shrink my pores and control sebum/acne. It helped but it certainly wasn't permanent like they described. I ended up having a total of three Erbium laser peels while using Celebre's skin care products, which I still broke out and suffered with acne while under their care. I was warned that the first Erbium wouldn't do anything; but it was necessary in order to remove the top layer of skin so that the second Erbium laser could work. That's a lot of pain, time and money (not to mention recovery time) that ended up doing nothing. After each procedure, the swelling set in and my scars appeared to be gone, only to reappear later. I wish I had shopped around and done more research back then. Fraxel lasers are better for deeper scars/wrinkles than Erbium. Also, I was given conflicting information by the different nurses at Celebre in between laser procedures. I wanted to move forward and get another Erbium laser done, one nurse Lori told me I was good to go while another nurse (Heidi I believe her name was) told me that I was no longer a candidate since I still had active acne. Well, I was using all of their skin care products and following all of their directions. This was very upsetting to me so I called and complained to the medical director. He apologized, investigated and ended up comping me an Erbium. Looking back, I will no longer allow an RN to perform any laser on me, only a Doctor.
2013-2014 - MixTo FRAXEL LASER - Still extremely frustrated with the appearance of my scene scars, I researched the different types of Fraxel lasers and discovered several sources claiming that the MIXTO fraxel was the best for treating acne scars. I found a Facial Plastic Surgeon in Laguna Woods that offers the MixTo Fraxel. Upon consulting with him (which was very nice consulting with an actual facial plastic surgeon vs. consulting with one of Celibre's Sales Staff who isn't even an RN) I was told that my scars are still so bad I'd need at least two Fraxel procedures performed. I decided to move forward and purchased two treatments, which were more cost effective than purchasing them individually. Same thing happened, after each Fraxel, my scars appeared to be "gone" but they'd slowly reappear when the micro swelling went away. My skin looked amazing and close to perfect a couple of months after the procedure, but sure enough, just like all of the other procedures they came back. *I did notice, however, that the Fraxel did get deeper, the oozing, crusting and sloughing of dead skin the first few days afterwards when washing with distilled water (thin pieces of your skin come off-it resembles fish food flakes if you've ever had a pet gold fish) were more apparent than with Celebre's Erbium. Still, even after two MixTo Fraxels from a facial plastic surgeon my acne scars were still horrendous, and I was still a "crater face." Keep in mind I'd saved up over the years in between procedures to be able to afford more lasers. There were times I didn't have enough $ saved (and I didn't want to finance, even though I could have) or I'd time the procedure during Spring Break or after finals when I was in college. Later, I'd have enough $ saved for the next laser but I didn't have enough PTO saved for recovery time. It was always a struggle.
2016 - Bellafill - Riviera Laser - Dana Point
Flash forward to today. I couldn't be happier being under Dr. Jeannine Kofford's care. I gave her my history and she stated that she believed the last facial plastic surgeon (I won't mention names, because he is a good "plastics" doc, just not as experienced in lasers as Dr. Kofford is. His area of expertise is with a scalpel, doing rhinos and brow lifts, not lasers) may not have gone deep enough with his Fraxel, probably in fear of leaving scarring or from lack of experience.
My very first procedure at Riviera was when Dr. Kofford removed two tiny cysts on my back (one I've had for years on my shoulder blade and another a few inches away). She used an Erbium laser combined with a small incision. I was SO impressed with her technique and how there was literally zero scarring afterwards that I followed her advice on trying Bellafill for my acne scars. (I've watched YouTube videos of cysts removed (e.g. Dr. Pimple Popper) and the majority of these Derms make an incision and dig the cysts out the old school way, which is more likely to leave a scar. Dr. Jeannine used her laser then was able to make a much smaller incision to get my cysts out.) Both cysts were smaller than a frozen pea and came out very clean, never to return. No Frankenstein sutures or scars!
After my first Bellafill follow-up appointment Dr. Jeannine mentioned how she'd love to do a Fraxel on me, now that my scars are raised from the Bellafill. I'm still considering having this done.
Conclusion
When I say that Dr. Jeannine is "the best" I sincerely mean it! I've spent a small fortune over the years trying various clinics and techniques just to be frustrated. Dr. Kofford and her staff at Riviera are truly the best in my very experienced opinion! My self esteem is so much better after Bellafill therapy. It's easier for me to go on job interviews, meet new people and even put up healthier boundaries in my relationships as weird as that sounds. I can maintain eye contact longer and I don't dwell and obsess on my acne scars nearly as much as I used to.
Where other physicians are too timid to get aggressive with lasers due to lack of experience, Dr. Kofford isn't! Normally the term "aggressive" is frowned upon in the dermatology industry, and it sounds scary to us consumers, but it is necessary to get results; otherwise you'll end up "treading water" and getting nowhere after spending thousands of dollars like me over the decades. I'm beyond grateful I gave Riviera Laser a try. I no longer have to shop around for a cosmetic dermatology practice.
Bellafill is amazing! I can't stress this enough! I was told that the specific type of hyaluronic acid in Bellafill will last up to 5 years. I'll consider myself lucky if I get 3 years out of it. I strongly feel like acne scars are a curse; an evil demon that continues to torchure and haunt you. I've tried SO many things in the past and no one, not even my mom, sister or closest friends can tell that I've had any lasers done a few months later. My scars always come back looking the same. ALWAYS. It is beyond detrimental to your mental health. If you're obese, there's so many treatment options that actually work: lap band, nutritionist, personal trainer, lipo. Same thing with people with horrible crooked teeth. It's an easy problem to fix. Go see an orthodontist and spend $2-3k and wear braces for 2-3 years. You many even need a few teeth extracted. Boom. Problem solved. Those of us who suffer from acne scars have very limited options. No matter what I tried they just never went away. Most of us have no choice but to just move on with our lives and live with acne scarring. I've postponed buying a house, getting married, having children, etc. and instead spent $ trying to better my complexion. Dr. Kofford and Bellafill so far have been the only thing that has helped me!
My "Baseline" photo is after 3 Erbium laser procedures at Celebre and 2 MixTo Fraxel lasers from the Facial Plastic Surgeon. My skin is pink/flush because I was giving myself a glycolic acid peel at home. All of the other pics are after my two Bellafill procedures.
I hope my review had provided some insight. I know I can't possibly be the only person that is frustrated and given up hope when it comes to acne scar reduction. I know that most people would have stopped after getting a few laser procedures performed after they noticed they didn't help much. Before another laser clinic or plastic surgeon talks you into yet another laser, give Bellafill and Riviera Laser Studio a try! Trust me!
Thank you for reading.