772-978-0484

Q:

What distinguishes it from other fillers on the market?

A:

Bellafill is the only FDA approved permanent filler. It is actually a hybrid product – 80% bovine collagen and 20% PMMA. The PMMA is the permanent component.

One of the misconceptions about Bellafill is that it is a one and done procedure. As the bovine collagen is reabsorbed, the PMMA microspheres are surrounded by macrophages and multi-nucleated giant cells along with bands of naturally produced collagen. However this volume is less than the bovine collagen that was injected, so there is an overall reduction in volume as compared with the immediate result. Subsequent injection sessions require fewer Bellafill syringes to achieve correction since they build upon the previous permanent PMMA filler base. Practitioners and patients need to understand that with Bellafill they are using a truly permanent facial filler but that a series of treatment sessions will be needed to achieve optimal results.

Q:

Please comment on Bellafill’s safety profile.

A:

The most common question that clinicians and patients have about Bellafill has to do with its safety profile. The obvious concern is that with a permanent filler, potential complications may be permanent as well. I think that there are three potential complications that need to be considered for anyone considering treatment with Bellafill.

Skin testing for bovine collagen allergy is recommended before treatment with Bellafill. Personally, I don’t perform the bovine collagen skin test, because bovine collagen allergy is quite unusual, and if it occurs, it is easily managed. I include the omission of the skin test in my written informed consent for patients. Also, a negative skin test is not entirely predictive, and a bovine collagen hypersensitivity reaction may still occur. I have seen this happen in patients with a negative skin test. But again, if it does occur, this problem is easily managed with a short course of corticosteroids and antihistamines. It is also completely reversible.

The second safety issue is the possibility of producing a nodule or lump. This complication tends to be related to sub-optimal injection technique. The product itself is very smooth and when properly injected nodules should be quite rare. That said, Bellafill should only be injected by highly experienced practitioners who have mastered facial injection techniques. If lumps or nodules do develop, they may be effectively managed with serial injections of corticosteroids with or without injection of 5 fluorouracil. On rare occasions, surgical removal may become necessary.

Granulomas are the other potential complication related to facial fillers, including Bellafill. The company completed a five year safety study in over 1000 patients that showed a five year rate of granuloma of 1.7%. Granulomas typically present as single or multiple inflammatory nodules in the regions where Bellafill was injected. They are managed with serial injections of corticosteroids with or without injection of five fluorouracil. In some cases, hyaluronic acid-based fillers may be required to camouflage the granulomas as they are resolving. It should be noted that granulomas represent an overly robust immunologic reaction to the PMM A microspheres, and favorably respond to corticosteroid injections. Surgical removal is inappropriate, medical therapy is the proper course of action.

vitals-award-182-wide

5 star rating

Q:

Who are good candidates for Bellafill?

A:

The best candidates for Bellafill are experienced patients who have had good results with facial fillers in the past, and are looking for a permanent result. For many people, facial filler fatigue may set in. It takes a commitment to continually see a practitioner for repetitive injections of temporary facial fillers. There are also many people who are thin, very active, and have higher metabolic rates who seem to require more frequent injections with temporary facial fillers. These fast metabolizer may also be good candidates for Bellafill.

Q:

Please describe patient satisfaction.

A:

Patient satisfaction is typically quite high. If you look on the website Real Self, Bellafill approval rating is 90%. My practice experience mirrors this positive patient response. The great majority of patients are satisfied and appreciate the permanent results. I often see return patients who remain pleased with the series of Bellafill treatments that they received years before.

Q:

Is there anything you would like to add?

A:

Although it is an off label indication, my use of Bellafill has evolved over the last five years. I now very often will use Bellafill as a deep structural filler directly on periosteum to mimic bone volume. This includes the malar eminence, the mandible, and chin. If you think about it, the truth is that this product may be used as a substitute for a surgical facial implant.

I am also several years into an FDA approved long-term safety and efficacy study of Bellafill for treatment of HIV related lipoatrophy. I have 30 subjects who have received over 30 syringes of Bellafill over a one year treatment and who then are followed for two additional years. The results have been overwhelmingly positive, and quite frankly, life-changing in this patient population.

I have surgeons and dermatologists who cite t permanent nature of Bellafill as the primary reason that they will not use this filler. For fair balance though, some of these practitioners would not hesitate to recommend a surgical procedure, which by their nature, may produce permanent problems as well.

Sign-up for our Email List

We will notify you for our specials and/or events

You have Successfully Subscribed!

Share This

Share This

Share this post with your friends!