TOPIC: Pmma after HA

So I had HA done with PhalloFILL. Love the
Results and the people. The problem I am having is I am loosing my gains faster than normal. Because of this I am considering Bellafill with Dr. Rupeka. My question is simple - has anyone had Bellafill or any PMMA after having HA ? Specifically adding the Bellafill without dissolving the initial layer of HA. I would appreciate any and all insights. TIA

HA duration is too short, that's the downside. I would suggest you check Ellanse, the consistency is good, and there is a recent article on the home page in the trending article section

I am not as concerned about the particular filler as I am the idea of injecting permanent filler over HA. Thanks

First, it's important to identify the specific type of HA filler that was used. Different HA fillers, such as Voluma or Volux, have varying degrees of longevity. If you're satisfied with the results from your current HA filler, you might want to explore these longer-lasting options before transitioning to a different type of filler.

Regarding the switch to Bellafill, there generally shouldn't be an issue combining it with HA fillers. Bellafill is suspended in collagen, and since your natural dermis is a mix of collagen and HA, these components are typically compatible. However, one aspect to consider is how Bellafill works. Bellafill encourages collagen formation as its carrier collagen is absorbed by the body, exposing the PMMA. If Bellafill is injected into HA, which is absorbed more slowly than collagen, the exposure of PMMA – and consequently, your own collagen formation – may be delayed. This isn't necessarily a negative; it could mean that you achieve your final results more gradually.

PMMA (like in Bellafill) and HA play well together.

Dr_Sullivan wrote: First, it's important to identify the specific type of HA filler that was used. Different HA fillers, such as Voluma or Volux, have varying degrees of longevity. If you're satisfied with the results from your current HA filler, you might want to explore these longer-lasting options before transitioning to a different type of filler.

Regarding the switch to Bellafill, there generally shouldn't be an issue combining it with HA fillers. Bellafill is suspended in collagen, and since your natural dermis is a mix of collagen and HA, these components are typically compatible. However, one aspect to consider is how Bellafill works. Bellafill encourages collagen formation as its carrier collagen is absorbed by the body, exposing the PMMA. If Bellafill is injected into HA, which is absorbed more slowly than collagen, the exposure of PMMA – and consequently, your own collagen formation – may be delayed. This isn't necessarily a negative; it could mean that you achieve your final results more gradually.

PMMA (like in Bellafill) and HA play well together.

Have you personally heard of or seen any patients that have had Bellafill injected into existing HA gradually over time? Just sheer curiousity

I've done it with good results. Usual scenario is that pt likes the HA and is now looking for something more long term

Dr_Sullivan wrote: I've done it with good results. Usual scenario is that pt likes the HA and is now looking for something more long term

So no dissolving the HA prior, just slowly start adding Bellafill?

Don't waste good HA. that is what I would do.

Thanks Dr. Sullivan. I would be very interested if anyone has actually had personal experience with this process.

Dr_Sullivan wrote: Don't waste good HA. that is what I would do.

Thank you for being candid. There seems to be that approach and then the 'must dissolve it all' approach. Interesting.

My understanding per @Avanti_Derma was that the collagen needed space to expand. Also mixing with HA would make it more prone to lumps and bumps as the ha dissolves.

Dickwhitman79 wrote: My understanding per @Avanti_Derma was that the collagen needed space to expand. Also mixing with HA would make it more prone to lumps and bumps as the ha dissolves.

The flip side of that is that Bellafill's carrier takes waaaay longer than Avanti Linnea's, so wouldn't it being in the HA be the same idea?

There's also different approaches to PMMA. Avanti likes moderate fills spread out, 20cc range. Rupeka, who is also a seasoned expert, takes a completely different approach, especially if he knows prior to any fills that your goals are significant. He'll do more like even 40cc range. My understanding of his reason (third hand however) is that it's easier for him to shape larger fills and fewer sessions means less fibrosis/scar tissue.

I'm not saying there's an answer or one method is better. Just asking questions so everything is out there.

I just had 20cc PMMA go in at Avanti Derma onSept 13,2023 after I dissolved 48cc of voluma that was injected a year or so prior.

Best thing to do is to get the HA dissolved and build solid base of PMMA. This is nothing to toy with. After having both types of filler and experiencing the integration process of both I strongly recommend dissolving the HA and starting PMMA injection with a blank canvas 30 days after your HA was dissolved. Also massage it a ton after they inject the hydrolanese so it disperses evenly to dissolve the HA well.


I am ecstatic about the results of the PMMA from Avanti Derma. They are amazing and my Cock turned out better than expected and feels amazing. I’m going back for another round to work on a few spots and increase Girth.

Good luck !

Majorgusto, thank you for your input, but I would still like to hear from anyone who has actually had Bellafill or PMMA layered over HA, and hear about their experience. Thank you to all who have contributed

To dissolve 1ml of Hyaluronic Acid, 100-150 units of hyaluronidase are required, with the higher end of this range typically needed for more robust formulations like Voluma. Consequently, dissolving 48 syringes of Voluma would require about 150 units per syringe, amounting to a significant cost. Specifically, the expense would be calculated as 48 syringes multiplied by 150 units per syringe, at a rate of approximately $2 per unit, totaling around $14,400. This estimation remains substantial even when considering that half of the Voluma may have degraded over time. Therefore, it's debatable whether a completely 'blank canvas' was achieved prior to subsequent treatments. If less hyaluronidase was used, it implies that a considerable amount of Voluma remained when Bellafill, another filler, was introduced. I don't know the specifics but something to ponder