The popularity of dermal fillers is skyrocketing and it currently stands as the second most popular minimally invasive cosmetic procedure in the United States. According to the American Society of Plastic Surgeons in 2020, more than 3.4 million people went to aesthetic processionals for dermal fillers. Although hyaluronic acid fillers have become the standard for most filler-necessitated treatments, they can leave something to be desired in terms of maintenance–effects fade after just 6-12 months. 

Bellafill® fills that gap in the aesthetics industry with a long-lasting solution. In fact, Bellafill® results can last up to five years and will not be reabsorbed into the body, making it a highly desirable option for clients who would like a low-maintenance approach to treating wrinkles, scarring, and much more. 

What is Bellafill®? 

Bellafill® is a first-of-its-kind dermal filler that has been FDA approved as a treatment for the nasolabial folds since 2006. In 2015, the FDA further approved it for the treatment of acne scars as well as deep-set wrinkles. According to the American Society of Plastic Surgeons, more that 70,000 people were treated with Bellafill®in 2020.

Bellafill®’s unique characteristics lie in its innovative formula: This solution is made of bovine collagen enhanced with polymethyl-methacrylate microspheres (PMMA). PMMA has been used for permanent surgical implants, so it has an extensive history of safe medical use. Bellafill® is the first product to employ PMMA shares in a gel form for insertion under the skin. It’s currently the only approved dermal filler that uses this combination of ingredients. 

Generally speaking, almost all dermal fillers work in the same way, regardless of formulation. They add instant volume to targeted areas of the face to define, combat laxity, or fill fine lines. Bellafill® is one of the few formulas that takes a different approach. Although clients will see some results right away–thanks to the bovine collagen in the formula that provides an immediate plumping effect–the additional wrinkle-smoothing effects increase over time. Similar to hyaluronic acid, the injected collagen gradually wears off but the PMMA spheres in Bellafill® do not reabsorb into the body. Instead, they remain under the skin, where they stimulate the body's natural collagen production. Because the solution is prompting your own natural processes, the results last much longer than traditional soft tissue fillers.

How does Bellafill® work? 

Bellafill® is classified as a dermal filler, so providers who are experienced with injecting fillers can add Bellafill® to their list of offered services. However, even experienced injectors should invest in training on the best methods of administering this product due to its semi-permanent nature. Unlike hyaluronic acid fillers, Bellafill® cannot be dissolved in-office. Once the product is administered, the only removal method is surgical. Though rare, some clients have complications after treatment, including nodules or granulomas under the skin. 

Don’t let the complications deter you, most clients report high, long-term satisfaction with Bellafill®. 

What tools do you need to administer Bellafill®?

Bellafill®, like most dermal fillers, requires minimal supplies to inject. You will need a 26-gauge needle per manufacturer recommendation. You'll also need refrigeration as the filler should be kept cold, at a temperature between 2–8˚C. The syringe should be brought to room temperature before treatment. 

Bellafill®’s formula does contain lidocaine, but you may want to supplement with ice or a topical numbing agent to make the treatment as comfortable as possible for your clients, 

As with any treatment, providers should use typical PPE during Bellafill® injection, including gloves and masks and eye protection, if necessary.

How long does treatment take? 

The length of a Bellafill® appointment will vary depending on treatment area, but is very comparable to standard dermal fillers. Targeted acne scarring may take less time to treat than deep-set periorial wrinkles. Be sure to set realistic expectations, as clients may need more than one appointment to get the desired results from Bellafill®. 

How can patients prep for treatment? 

Because Bellafill® has the potential to cause allergic reactions, recommend that your clients come in for a patch test four weeks prior to their appointment. The manufacturer recommends administering a small injection into the forearm to check for any signs of allergies. If the client has a reaction, they should not pursue Bellafill® and instead you can work with them to find alternatives treatment options. 

Most clients do not need special preparation before Bellafill® injections. Speak with your client about their overall health and any medications they may be taking. Certain medications can increase the risk of bleeding or bruising at the injection site, so advise clients to taper off appropriately. If there are questions about the safety of Bellafill® and prescription medications, the client should speak with the prescribing physician before their appointment. 

What is the recommended post-treatment care? 

Most people have very little discomfort after Bellafill® injections and don’t need to take any significant steps for after-care. The most common side effects include:

• Bruising
• Itching
• Pain/Soreness
• Redness
• Swelling
• Tenderness

If clients have discomfort, they can self-soothe with cold compresses, but any side effects should resolve within 3-7 days. Clients should avoid touching or scratching the injection site to avoid infection or migration. They should also keep the area clean and call you if they notice increased pain, swelling, fever, or signs of infection. 

Who can perform this treatment? 

Every state has its own regulations about who can administer injectable treatments such as dermal fillers. Medical doctors are permitted to perform all cosmetic treatments. In many states, such as Texas and California, certified physician assistants, registered nurses, and nurse practitioners can offer injectables if they’re working under the supervision of an M.D.. Check the regulations in your home state for precise guidance.

Bellafill® is best administered by providers with experience injecting fillers. For the injection process, the manufacturer recommends using “a standard linear threading technique, moving the needle back and forth beneath the skin being treated and maintaining constant injection pressure while withdrawing the needle (retrograde liner threading).” 

Regardless of certification and prior experience, providers should be sure to have appropriate training before offering Bellafill® to clients. Since this is an irreversible treatment, it’s important for providers to be properly prepared to give clients the best possible results. 

Who is the ideal candidate? 

Bellafill® can be used for a wide variety of clients: It is approved for any client over the age of 21 who has moderate-to-severe acne scarring or noticeable wrinkles in the nasolabial folds. The FDA has not approved using Bellafill® for lip augmentation, because of the risk of granuloma formation. 

Clients who are immunocompromised, have bleeding disorders or have a history of excessive scarring should discuss their risks before treatment. In addition, Bellafill® is not appropriate for people with allergies to lidocaine or bovine collagen. Clients with these allergies should explore alternative treatment options. 

What are the benefits? 

Bellafill® is highly effective for treating the appearance of deep-set wrinkles and acne scars. The initial injection inserts collagen under the skin so that there is an immediate smoothing effect. Over time, the body absorbs the collagen, leaving only the PMMA spheres, stimulating natural collagen production and providing a framework to secure the new collagen in place. The smoothing effects will gradually increase over the first several months after the treatment.

Bellafill® is a safe and effective service that you can offer as a treatment in your studio. Clients who are experienced with fillers may be more comfortable opting for a long-lasting solution. Be sure to adequately prepare clients that are new to fillers to ensure they understand the risks and benefits before treatment.

To learn more about offering this service as a provider, contact a Portrait specialist today.

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