CosmeticBoard
Q: If Bellafill or PMMA was injected into the tear trough of the eyelids, can it be removed? I had Bellafill injections under my eyes and into the cheeks and smile lines.
A: Bellafill is a PMMA filler that is composed of acrylic microbeads that are embedded in a collagen matrix. Once the collagen material is dissolved by the body, you will likely have exposed free acrylic microbeads trapped within the soft tissue. Although some patients are told that Bellafill is a 5-year filler, the likelihood that the beads will remain trapped within your tissue for life is very high. To date, I don’t know of a single mechanism to non-surgically remove Bellafill from the soft tissue and skin.
That said, in my office I use a non-surgical approach to break down some of the fibrotic soft tissue scarring that forms around the bellafill, thus reducing the inflammatory burden and soft tissue scarring that causes granulomas to be felt under the skin. Tear trough Bellafill is particularly problematic underneath the thin skin of the eyelid; and this should probably be removed with surgery.
In my experience with Bellafill of the lower eyelid, I use either a direct approach or subciliary oculoplastic approach to remove the material that is trapped within the eyelid muscles. The procedure is tedious and I do not recommend the procedure with surgeons who are not familiar with oculoplastic technique.
It is much harder for me to remove the Bellafill from the cheeks than the lower eyelids. I would begin with a consultation so that I can examine the skin and subcutaneous PMMA. Granulomas and inflammatory nodues should be reduced before surgery in order to consolidate the mass. If you live out of the United States, our office can help accommodate a consultation.
Best,
Dr. Karamanoukian
Realself100 Surgeon