| Category Name | Content |
| Name | Bellafill (Polymethyl Methacrylate (PMMA) Microspheres with Bovine Collagen) |
| Uses | FDA-approved for nasolabial folds and acne scars. Used off-label for facial volume restoration (excluding lips). |
| Route of Administration | Intradermal or subdermal injection. |
| Frequency of Use | Max every 3 months for elective patients. Long-lasting effects (5+ years) require conservative dosing. |
| Concentration(s) | Available as 0.8 mL and 1.0 mL syringes with 20% PMMA microspheres suspended in 80% bovine collagen. |
| Maximum Dosage | Max 2.0 mL per session. Max 4.0 mL per 3-month period. |
| Contraindications | • Pregnancy, breastfeeding, or planning pregnancy. • Allergy to bovine collagen or lidocaine. • History of severe allergies, anaphylaxis, or autoimmune conditions. • Prior history of granulomas, hypertrophic/keloid scarring. • Active skin infections, acne, or inflammation in the treatment area. • History of embolism, necrosis, or vascular occlusion from previous procedures. • Use of blood thinners or immunosuppressive medications. |
| Possible Side Effects | • Common: Swelling, bruising, tenderness, redness at injection sites. • Rare: Vascular occlusion, granuloma formation, nodules, hypersensitivity reactions. • Severe: Anaphylaxis, arterial embolization, tissue necrosis (requiring surgical intervention). |
| Compatibility With Other Treatments/Drugs | • Safe with: Neuromodulators (Botox, Dysport), most HA fillers. • Avoid with: Recent laser treatments, chemical peels, or other dermal fillers within the last 3 months. |
| Allergies | Patients allergic to bovine collagen, lidocaine, or polymethyl methacrylate should not receive treatment. |
| Administration Time | Injection procedure takes approximately 30–45 minutes, including preparation and aftercare. |
| Dosing/Settings | Start with conservative volume (e.g., 0.5 mL per area) and reassess at follow-up visit. |
| IM/Push (if applicable) | Not applicable; should only be administered intradermally or subdermally. |
| What To Do If Adverse Reaction Occurs | • Vascular occlusion: Stop injection immediately, apply warm compress, massage area, administer hyaluronidase if needed. • Anaphylaxis: Administer epinephrine (0.3 mg IM), call 911, provide airway support. • Granulomas: Refer to dermatology for corticosteroid or 5-FU treatment. • Necrosis: Immediate referral to a specialist for wound care and potential debridement. |
| Additional Documentation Requirements | • Signed informed consent form. • Pre-treatment photos (frontal and side views). • Medical clearance if history of vascular complications, autoimmune disease, or recent oncology treatment. • Documentation of past filler treatments and allergy history. |