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Bellafill® (formally Artefill®) is an injectable filler that provides natural looking correction while restoring facial volume. It is also effective in the treatment of acne scars.

Bellafill® is different from temporary injectable fillers. The unique microspheres in Bellafill® are not absorbed by the body and provide the support your skin needs for natural looking results. It also has been found to last longer* than other fillers.

If you have used temporary fillers in the past, then you know that they are eventually absorbed by your body and require frequent repeat injections to maintain the results you’ve come to love.

Dr. Pierone is the leading injector of Bellafill® in the United States and is a nationally recognized trainer and researcher. He has performed over 20,000 procedures with dermal fillers.

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How Does it Work?

Bellafill® is an FDA-approved, natural looking dermal filler comprised of collagen and PMMA microspheres.


bellafillUnlike other types of fillers, Bellafill® replaces collagen in the face and restructures the skin to support natural looking results.

The effects of Bellafill® come from the collagen, which is absorbed by the body over time. The PMMA microspheres provide enduring wrinkle correction by creating a support matrix for the body’s natural collagen. The unique microspheres in Bellafill® are not absorbed by the body and create a support matrix for wrinkle correction by working together with your body’s own collagen.

Upon injection, the collagen in Bellafill® visibly reduces the wrinkles right away and the microspheres provide support for your skin. Your body’s own collagen works together with the microspheres to provide natural feeling wrinkle reduction.

Body Area(s) & Procedure(s)

The U.S. Food and Drug Administration (FDA) has recently approved the dermal filler, Bellafill®, for the treatment of acne scars.

Bellafill Pricing

Bellafill® / Artefill® is priced $800 per syringe and $3,500 per box of 5. A full treatment can require anywhere from 2-5+ syringes. Product duration 5+ years.

What to Expect

Bellafill® is injected with the assistance of a microcannula, the latest revolution in injection techniques!

Here's what to expect:

Using a technique known as skin sculpting, we will literally slide the Microcannula under your skin so that the filler can be applied with practically no pain or bruising for the patient.

There is typically a low incidence of side effects with Bellafill®, but expect redness after treatment, mild swelling and mild discomfort 24 hours after treatment.

Important Safety Information
Bellafill® is indicated for the correction of nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21 years.



What distinguishes it from other fillers on the market?
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.

Please comment on Bellafill's safety profile.
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.

Who are good candidates for Bellafill?
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.
Please describe patient satisfaction.
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.
Is there anything you would like to add?
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.

Is it safe?
Bellafill® is indicated for the correction of nasolabial folds and moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21 years. Patients who have had a positive reaction to the Bellafill® Skin Test, have a history of severe allergies, have known bovine collagen allergies, are allergic to lidocaine, have bleeding disorders or are prone to thick scar formation and/or excessive scarring should not receive Bellafill®. The safety of Bellafill® for use during pregnancy, breastfeeding, or in patients under 21 has not been established. You may experience temporary swelling, redness, pain, bruising, lumps/bumps, itching, and discoloration at the treatment site. These side effects are usually transient and typically resolve within 1–7 days. You may experience lumps/bumps/papules that may occur more than one month after injection and that may persist. Less common side effects include rash and itching more than 48 hours after treatment, persistent swelling or redness, lumps/bumps, acne, and increased sensitivity at treatment sites. Infrequently, granulomas may occur and may be treated by Dr. Pierone. Based on the 5-year Post-Approval Study on nasolabial folds with 1,008 patients, long-term safety of Bellafill® for up to 5 years has been established.(2)
Will it work for me?
In a clinical trial, Bellafill® was shown to work equally well with all skin types, and in men and women. Patients who have had a positive reaction to the Bellafill® Skin Test, have a history of severe allergies, have known bovine collagen allergies, are allergic to lidocaine, have bleeding disorders or are prone to thick scar formation and/or excessive scarring should not receive Bellafill®.
When will I see results?
Bellafill® replaces lost volume in the skin below the wrinkle for correction that is noticeable and lasting.(2)
What's the downtime?
You can return to normal activities right away. As with any injectable dermal filler, you may experience temporary swelling, redness, pain, bruising, lumps/bumps, itching, and discoloration at the treatment site. These side effects are usually transient and typically resolve within 1-7 days.
How long does it last?
The PMMA microspheres provide a microscopic ‘matrix’ to support your body’s own natural collagen production and re-create the firm structure of younger-looking skin for lasting correction, proven effective through 5 years(2). This number is potentially much higher but has not been tested in long duration clinical trials.
References: 1. Gottfried Lemperle, et. al., ArteFill® Permanent Injectable for Soft Tissue Augmentation: I. Mechanism of Action and Injection Techniques., Aesthetic Plast Surg. 2010 Jun;34(3):264–72. 2. Bellafill® [Instructions for Use]. San Diego, CA: Suneva Medical, Inc.; 2015. 3. Jacob CI, Dover JS, Kaminer MS. Acne scarring: A classification system and review of treatment options. J Am Acad Dermatol; July 2001; 109-117. 4. Data on file. Suneva Medical, Inc. 5. Haneke et al. Polymethyl Methacrylate Microspheres in Collagen. Semin Cutan Med Surg 23:227-232,2004. 6. Cohen et al. Artecoll: A Long-Lasting Injectable Wrinkle Filler Material: Report of a Controlled, Randomized, Multicenter Clinical Trial of 251 Subjects. Plast. Reconstr. Surg. 114: 964,2004. 7. American Academy of Dermatology, 8. Journal of Plastic, Reconstructive and Aesthetic Surgery, 2008, 9. Formula PR Independent Study, 2013. 10. Suneva Medical AAD Advisory Board, August 2015, data on file.

5 Star Reviews

Real Patients

  • Dr. Pierone and his staff are so kind and welcoming. His compassionate and conservative approach never leaves you feeling "overdone." He is very knowledgeable and patient while discussing your desired results and is very sincere with his approach. He takes the time to listen to what your goals are and is excellent at explaining the options and details of what is needed to achieve them. It is important to him that all of his patients are pleased with their results and is willing to go above and beyond, when necessary, to make that happen. You rarely find that anywhere, folks! I am glad and grateful to have found him. Thank you, Dr. Pierone!

  • I went to Dr. Pierone at One Aesthetics for Bellafill training and it was so much more than I could have possibly hoped it would be! He and the rest of the staff were wonderful and made me feel so welcome! He taught me far beyond what I had hoped to learn from the experience. If you are looking for training in regards to filler (including Bellafill), botox, PDO threading or any other injectables, I would highly recommend them!!

  • By age 42, I realized that I was losing volume around my cheekbones, and nasolabial folds were becoming more obvious. After reading extensively about various facial fillers, I decided to try Bellafill. I liked the fact that, according to the published product info, it lasted so much longer than the other fillers. I continued researching online and discovered that Dr. Gerald Pierone in Vero Beach, FL was the authority on this particular product. There are many doctors who will inject with Bellafill, but Dr. Pierone has much more experience and history using this product that any other doctor out there. I called Dr. Pierone’s office in Vero Beach, FL and spoke with one of his representatives there. She answered my questions, but I also asked to speak to Dr. Pierone. Bear in mind, this is typically not an option. Most doctor’s offices request (understandably) that you go in for a consultation to speak to the doctor. Much to my surprise, Dr. Pierone took the time to call me personally! I’m so glad he did. He actually suggested that I try some temporary fillers to start with so that I would at least have an idea of what to expect. He was kind, down to earth, and extremely professional. I was VERY impressed with his warmth and manner, and blown away by the fact that he took the time to call me.

    I took Dr. Pierone’s advice and went to my dermatologist for Voluma injections in my cheeks. I LOVED the results. The volume it added to my cheeks and under my eyes took years off my appearance without making me look “different”. The result was just a fresher, more rested youthful me! I was told the Voluma injections would last at least a year. Unfortunately, the results I loved barely lasted 3 months. I tried Radiesse next. I also loved the results of that filler, but the results only lasted about 3 to 4 months for me. By this time, I felt confident that I did like the results facial fillers, but there was no way I could afford to pay thousands every few months to maintain the results. I just needed something that would last longer. I contacted Dr. Pierone’s office in Vero Beach (Facial Rejuvenation, FL) and was told that he also offers services at “One Aesthetics” in Winter Park, FL (close to Orlando) for the convenience of patients flying or travelling from out of town. I called One Aesthetics and spoke to Amie Evans. Amie, like Dr. Pierone, was incredibly kind and patient. She answered all my questions (I had many) and we scheduled my consultation/injection at the same time since I was flying in from out of town. Bear in mind, about 2 years had passed since I spoke to Dr. Pierone…, I was incredibly excited to finally have the Bellafill injections. Upon arriving at One Aesthetics in Winter Park, I was greeted by Mark Evans, Amie’s husband. Together Amie and Mark operate One Aesthetics. Mark was super sweet and made me feel right at home. I know that going on and on about all of these folks and saying how kind, down to earth, professional, etc. sounds ridiculous, but it’s all true! I was COMPLETELY blown away by ALL of these guys. I can say that I am a very good judge of character and the caring and compassionate attitude that I received from Dr. Pierone and the One Aesthetics team was GENUINE. It was obvious that I was in capable hands, and better yet, in the hands of people who really cared.

    The injections themselves were practically painless, thanks to the “micro-cannula” Dr. Pierone uses to inject the Bellafill. Dr. Pierone was even more wonderful in person, once again patiently answering my questions beforehand. The best part of all…..I LOVE my results. Even more than the other fillers! Dr. Pierone is definitely the BEST injector I have had. The other Doctors who injected me were also good. I did my research and chose them carefully as well, but even so, Dr. Pierone IS THE BEST. He knows exactly how to place the filler depending on the areas of concern, facial symmetry, etc. The results were flawless! In the months following the Bellafill injections, I have had some volume loss (which is normal with Bellafill), but I go back in just a few weeks for another treatment. Dr. Pierone described it to me as “a marathon, not a race”, which is correct. The correction is long lasting….up to 5 years or more according to studies. But it will take 2 or 3 treatment sessions to achieve full correction. I would say that I maintained at least 70% correction after this first treatment. Better yet, the level of correction that I have maintained is not diminishing. It has been around 4 months since the injections and normally, with other fillers, I would have lost most of the correction. Not with this product. I am already feeling confident that it will last a very long time. Dr. Pierone is conservative in his treatment too, which I like. You can always add more, but you can’t subtract.

    I would highly recommend Dr. Pierrone to anyone considering injections of any kind, but in particular I would urge anyone considering Bellafill to choose Dr. Pierrone for that treatment. Bellafill is permanent, so obviously there is no room for error with this filler.

    I’m looking forward to seeing all my friends at One Aesthetics in just a few weeks. I know I’ll be thrilled with my results, once again.


    Timothy Ginn

  • I just wanted to send a quick note to thank you for all your assistance with the patient assistance programs. I will be back in October and will continue treatment with Dr Pierone. I was in the office yesterday and was hoping you would tell Dr Pierone that I woke up this morning and my face looks AMAZING!!! I am SO GREATFUL to all of you and PLEASE tell the Dr his work is SHEAR PERFECTION and thank him again for me. I figure that having you relay this message to him would insure he gets it since I’m sure he has a very busy schedule.

  • My experience at One Aesthetics has been superb and I highly recommend them. The entire staff is friendly, knowledgeable, and professional. Amie, Mark, Jaime, Becky , and all the ladies are so gracious and made me feel very comfortable. I had my very first laser facial treatment done by Jaime whom explained the procedure in detail. So, I went back for five more treatments and Jaime did a fabulous job. To save the best for last would be to speak about Dr. Pierone. Dr. Pierone in his patient gentle voice explained to me how he could transform my face and neck into a more natural youthful look. Then, my experience began with the best injector aka Dr. Pierone using Bellafill and from there he began to patiently transform me. Dr. Pierone used PDO threads, Voluma, and other innovative techniques to get the best results for me. Dr. Pierone had the knowledge, expertise, and experienced eye to make my experience a success. When my friends stated "you look rested" ; then, I knew I had the best doctor working on my face and neck. I appreciate immensely all that Dr. Pierone has done for me. Thank you One Aesthetics for this incredible experience.

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