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BellafillI know that Bellafill(Artefill) can be controversial since it is a permanent filler.  However, I have used it without any real issues for a few years now in almost every part of the face excepting the lips, where it is poorly indicated.  I find it remarkably easy to use and much more effective than almost any hyaluronic acid so long as the patient understands the risks (it is permanent) and the limitations of the product.  The major limitation of the product other than the fact that it is permanent is that you lose about 20% after each injection.  The reason for this limitation is that 80% of the product is actually bovine collagen that tends to dissipate over a period of 4 to 6 weeks.  During this time, your own natural collagen moves in to replace the temporary collagen but not at a 1:1 ratio, more like at a 0.8:1 ratio, i.e., 80% or so of the result is typically maintained.  I also like the product for this reason in that after a month, you don’t have product that moves at all.  Sometimes an individual that has a lot of hyaluronic-acid product can have the product slightly (not greatly) migrate or be pushed after sleeping since the product typically does not have tissue integration like Bellafill.  Since the product requires a skin test performed a few days before a procedure can be performed, this can pose as a negative issue especially for individuals flying in to see me. I typically wait at least 3 days before performing a procedure since the odds of an allergic reaction at that point is less than perhaps 1:1,000 patients or even less.  Some individuals argue that one should wait several weeks to evaluate for possible reaction.  However, I believe that almost any reaction that could occur should arise within 48 to 72 hours.  Many physicians do not even perform a skin test but I still do, as I have had 6 patients out of perhaps 2,000 with a reaction.

Sam M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a consultation please call (972) 312-8188. To Learn more about Dr Lams’ Bellafill procedures or to ask Dr Lam a question please visit his Cosmetic Injectables and Fillers Forum