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What Does Adequate Correction With Bellafill Really Mean?

Posted: 12:01 a.m. Sunday, Apr. 21, 2019

By Anita Mandal, M.D.
Question: I am interested in Bellafill for the volume loss in my cheeks, temples and under the eyes but am just afraid to look unnatural. How do I know if the amount recommended will be enough, too little or too much?

Answer: One of my main guidelines for determining how much Bellafill to recommend is based on the adequate correction threshold. I define adequate correction as the amount estimated to create a worthwhile result that the patient is happy with.

If the amount of Bellafill used is less than that needed for adequate correction, a patient may see no visible result or only have a partial result that they are not happy with. For example, someone with significant temple hollowing may need a total of 4 syringes, meaning 2 on each side to adequately correct the volume loss. If this patient decides they only want half of this amount, believing that 2 syringes can restore 50 percent of their temple volume, they may likely be dissatisfied. When 4 syringes are needed for adequate correction, but only 2 syringes are performed, the patient may only have a 25% improvement that is minimally visible.

Each treatment area has a volume restoration threshold. If you fail to use enough filler to reach that threshold, you may not see much of a result. When it comes to injectable fillers, the result is not necessarily directly proportional. You often first have to add enough filler to reach the adequate correction threshold.

On the other extreme, if the amount of Bellafill used is more than that needed for adequate correction, the result can often appear overdone and unnatural. For example, someone with hollow temples and cheeks needs 4 syringes in the temples and 4 in the cheeks. However, they insist, after having 2 syringes in the temples, that the remaining 6 syringes should be put into the cheeks which they believe are the worst aspect of their aging. Using more than required for adequate correction can give the patient an overfilled cheek with facial disproportion due to failure to address the temple imbalance. This could make one’s face look very different and unnatural.

Seeking a Board Certified Facial Plastic Surgeon who understands the detailed anatomy of facial aging and knows the proper threshold for adequate correction with regards to facial volumization is key. Having treatments by someone who simply does a lot of injectable filler treatments does not necessarily qualify them as an expert injector for facial volume restoration. A natural looking result often lies in the details of evaluation and treatment by a true specialist.


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