Bellafill
Bellafill is the longest-lasting dermal filler available, with FDA approval for five years — and the only filler FDA-approved for acne scarring. It combines collagen for immediate volume with PMMA microspheres that remain permanently as a scaffold for your own collagen. It requires an allergy skin test before treatment and cannot be dissolved. Bellafill is $950 per syringe at Naficy Rejuvenation Center in Bellevue, Washington.
This page covers Bellafill. To compare it against Juvéderm, Restylane, Radiesse and Sculptra, see the facial fillers overview.
What is Bellafill?
Bellafill — formerly sold as ArteFill — has two components:
- Bovine collagen (80%), which provides volume immediately and is gradually absorbed over the following months
- PMMA microspheres (20%) — polymethyl methacrylate, a biocompatible material used in medicine for decades. These are not absorbed. They remain in place and act as a permanent scaffold that your own collagen grows around
So the visible result on day one is collagen; the durable result is your own tissue, supported by a scaffold that stays. This is why Bellafill outlasts every other filler — and equally why it demands more care in placement.
How does Bellafill compare with other fillers?
| Bellafill | Radiesse | Juvéderm / Restylane | |
|---|---|---|---|
| Material | PMMA in bovine collagen | Calcium hydroxylapatite | Hyaluronic acid |
| Duration | 5 years (FDA-approved) | 12–18 months | 6–24 months |
| Permanent component | Yes — PMMA remains | No | No |
| Reversible | No | No | Yes |
| Allergy test required | Recommended — 3–4 weeks before, although many patients waive this recommendation | No | No |
| FDA-approved for acne scars | Yes — the only filler with this approval | No | No |
| Suitable for lips | No | No | Yes |
Before & After Bellafill injection. * Individual results may vary.
Bellafill for acne scars
Bellafill is the only dermal filler FDA-approved for the correction of moderate to severe atrophic acne scars on the cheek in patients over 21.
Rolling and boxcar scars — the broad, saucer-shaped depressions — respond best, because the product lifts the depressed area from beneath. Ice-pick scars, which are narrow and deep, respond poorly and are better addressed with laser resurfacing or other techniques.
The appeal for acne scarring is durability: temporary fillers mean re-treating an extensive scar pattern indefinitely, which becomes expensive and tedious. A treatment measured in years changes that calculation.
What else does Bellafill treat?
- Nasolabial folds — its original FDA indication
- Marionette lines
- Atrophic acne scarring on the cheeks
- Deep static folds where longevity is the priority
Bellafill is not used in the lips or under the eyes. Both are mobile, thin-skinned, and unforgiving, and a product with a permanent component does not belong in either.
Before & After Bellafill injection. * Individual results may vary.
Why does Bellafill require a skin test?
Because it contains bovine collagen, a small proportion of people may be allergic to it. A skin test is recommended on the forearm and evaluated three to four weeks before treatment. At time patients may decline this skin test and proceed to treatment without it.
How much does Bellafill cost?
Bellafill at Naficy Rejuvenation Center costs $950 per syringe. Acne scar treatment typically requires more product than folds, and the amount depends on how extensive the scarring is.
The value case is longevity: a five-year product compares favourably against a hyaluronic acid filler repeated every 6 to 18 months over the same period, particularly for acne scarring where re-treating a broad area repeatedly becomes costly.
Non-surgical pricing · Current specials · Financing
How long does Bellafill last?
Five years, established in the FDA approval trial — longer than any other filler. The PMMA microspheres remain permanently, so a degree of correction can persist beyond that.
Does it hurt, and what is the recovery?
Bellafill contains lidocaine and topical numbing is used. Expect swelling, bruising and tenderness for several days. Judge the settled result at two weeks; acne scar treatment continues improving over months as collagen forms around the microspheres.
Who is a good candidate for Bellafill?
- Moderate to severe rolling or boxcar acne scarring on the cheeks, over the age of 21
- Deep nasolabial folds or marionette lines where longevity is the priority
- A negative skin test
- Someone who has had temporary fillers, knows what result they want, and wants it to last
- Comfort with a product that cannot be reversed
Who is not a good candidate?
- A positive skin test, or any history of bovine collagen allergy.
- You have never had filler before. Starting with a five-year product is the wrong order. Establish what you like with something reversible first.
- You want lip or under-eye treatment. Bellafill is not used in either.
- Ice-pick acne scars. Too narrow and deep for a filler to lift — these need resurfacing or excision.
- A history of keloid or hypertrophic scarring, or a tendency to granuloma formation.
- You want the option to change your mind. Choose hyaluronic acid.
- Pregnancy or breastfeeding.
What are the risks?
Common and temporary: swelling, bruising, redness and tenderness at the injection sites.
Less common: lumps or bumps, particularly if placed too superficially; asymmetry; persistent redness; and infection.
The risks specific to a permanent product:
- Granuloma formation — a delayed inflammatory nodule around the microspheres, which can appear months or years afterward. Uncommon, but it is the recognised risk of permanent fillers and it can require steroid injection or surgical removal.
- Allergic reaction to the bovine collagen — the reason for the skin test.
- Irreversibility. There is no dissolving agent. An unsatisfactory result cannot be undone by waiting, because the PMMA does not go away.
Rare and serious: vascular occlusion. As with Radiesse, this carries added weight because there is no reversal agent.
None of this is a reason to avoid Bellafill in the right patient. It is a reason to be certain you are the right patient, and to have it placed by someone who does this regularly and conservatively.
Bellafill injection for acne scars. * Individual results may vary.
Bellafill and future facial surgery
This is the consideration most rarely raised at the time a permanent filler is injected, and it belongs in the decision.
Permanent fillers make a subsequent facelift dissection harder. Because the PMMA microspheres remain in the tissue indefinitely, the surgical planes are less distinct, separation is less clean, and the operation takes longer.
Dr. Naficy performs deep plane facelifts, and this is his own observation from operating: he has not encountered dissection difficulty attributable to Sculptra, but he has encountered it with permanent fillers.
What this does not mean. It does not make you inoperable. Patients who have had Bellafill go on to have facelifts and get good results. The surgeon simply needs to know in advance, and the dissection takes more care and more time.
What it does mean. If you are weighing a permanent filler against a temporary one, and facial surgery is a possibility within the next decade, this is part of the calculation. A five-year product is a longer commitment than the fee alone suggests.
It reinforces the recommendation elsewhere on this page: for most patients, establish what you like using a reversible hyaluronic acid filler first, and reserve a permanent product for when you are confident about the result you want.
See the facelift page for how each category of filler affects surgery.
Who injects Bellafill here?
Five injectors, two of whom are national trainers for Allergan Aesthetics and Galderma. More than 10,000 filler treatments are performed here each year, within a surgical practice with a board-certified plastic surgeon on site — which matters more than usual with a product that cannot be reversed.
Bellafill before and after photos
Before and after photographs of Bellafill treatment at Naficy Rejuvenation Center. Individual results vary.
Bellafill injection for acne scars. * Individual results may vary.
Frequently asked questions about Bellafill
Will Bellafill affect a facelift later?
It can make the dissection harder, since the PMMA microspheres stay in the tissue permanently and the surgical planes are less distinct. It does not make surgery impossible — patients who have had Bellafill have facelifts and get good results — but the surgeon needs to know beforehand and the operation takes longer. Worth weighing if facial surgery is a possibility within the next decade.
How long does Bellafill last?
Five years, established in the FDA approval trial — the longest-lasting dermal filler available.
How much does Bellafill cost in Seattle?
At our practice, $750 to $990 per syringe. Acne scar treatment usually requires more product than fold correction.
Is Bellafill permanent?
The PMMA microspheres are permanent and are never absorbed. The collagen component is absorbed within months. FDA approval covers five years of effect.
Can Bellafill be dissolved?
No. There is no reversal agent. This is the single most important thing to understand before choosing it.
Is Bellafill good for acne scars?
Yes — it is the only filler FDA-approved for atrophic acne scarring. Rolling and boxcar scars respond well; ice-pick scars do not.
Why does Bellafill need a skin test?
It contains bovine collagen, to which a small proportion of people are allergic. The test is done on the forearm three to four weeks before treatment.
What was Bellafill called before?
ArteFill. The formulation was refined and rebranded as Bellafill.
Can Bellafill be used in the lips?
No. The lips are mobile and thin-skinned, and a product with a permanent component is not appropriate there.
Is Bellafill safe?
It has FDA approval and a long clinical record. Its distinct risks are allergy, which the skin test screens for, and delayed granuloma formation, which is uncommon but is the recognised trade-off of a permanent filler.
Should I try a temporary filler first?
Usually yes. Establishing what you like with a reversible product before committing to five years is the sensible order, and it is what we recommend to most patients considering Bellafill.
Next steps
A Bellafill consultation is mostly about whether the permanence is right for you. For the right patient — particularly with acne scarring — it is the most durable option available. For someone still deciding what they want, a reversible filler is the better starting point, and we will say so.
Naficy Rejuvenation Center is located in Bellevue, Washington, and serves patients from Seattle, the Eastside, and throughout the Pacific Northwest.
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Medically reviewed by Sam Naficy, MD, FACS, board-certified by the American Board of Facial Plastic and Reconstructive Surgery.
