Bellafill
Acrylic beads in cow collagen Tiny acrylic beads float in a liquid made of cow collagen, lidocaine and buffered water. The beads are the part that stays.
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Dermapedia / CompareProcedures
Bellafill vs Juvederm
The main difference is whether you can undo it. Bellafill is built around tiny acrylic beads the body never absorbs, so surgery is the only sure way to remove it. Juvederm is a hyaluronic acid gel, and an enzyme can dissolve it. That one difference drives most of the decision.
At a glance
| The difference | Bellafill | Juvederm |
|---|---|---|
| What it is made of | Acrylic beads in cow collagen | Hyaluronic acid gel with lidocaine |
| Cost | Higher up front, no repeat purchase | Lower each time, paid again over time |
Juvederm
Side by side
The differences that matter
What it is made of
Bellafill
Acrylic beads in cow collagen
Tiny acrylic beads float in a liquid made of cow collagen, lidocaine and buffered water. The beads are the part that stays.
Juvederm
Hyaluronic acid gel with lidocaine
A cross-linked hyaluronic acid gel with lidocaine mixed in. Each product in the family is a different thickness, made for a different area.
Does it go away
Bellafill
The carrier does. The beads do not
The cow collagen carrier is absorbed over one to three months. Your own collagen forms around the beads, and the beads stay where they were placed.
Juvederm
Yes, over months to a couple of years
How long it lasts depends on which product was used and where it was placed.
Can it be undone
Bellafill
No. Surgery is the only way out
Hyaluronidase, the enzyme used to dissolve filler, has nothing to act on in an acrylic bead. Steroid injections can calm an inflamed lump, but they treat the reaction, not the material.
Juvederm
An enzyme dissolves it
Hyaluronidase works, but not equally well across the family. The thicker products need a lot of enzyme. In the US, dissolving filler is an off-label use.
The skin test
Bellafill
Required, for cow collagen sensitivity
A skin test is required first, because the carrier comes from a cow. Ask the clinic how far ahead they place it, when they read it, and what a positive result means.
Juvederm
None needed
Hyaluronic acid is made by bacterial fermentation. Nothing in it comes from an animal.
Cost
Bellafill
Higher up front, no repeat purchase
The last published society figure, from 2023, was $901 for non-hyaluronic acid fillers, the group Bellafill sits in. A permanent product removes the repeat purchase. It also removes the chance to stop.
Juvederm
Lower each time, paid again over time
The same 2023 figures put hyaluronic acid fillers at $715. Both numbers are surgeon fees per procedure, not the price of a syringe.
The at-home version
Bellafill
There is no home version
Nothing sold over the counter puts a permanent bead under your skin. A cream stays on the surface, and this treatment works several millimetres down.
Juvederm
Lip plumpers are not filler
A serum sits on the skin and stays there. A plumper mildly irritates the lip so it swells for a few hours. Neither places gel under the skin.
Who tends to be happy with it
Bellafill
- Best for — Someone who has had temporary filler in the same spot. They liked what it did, and want to stop repeating it.
- The mindset — A decision with no reverse gear. Start with less than you think.
Juvederm
- Best for — Almost everyone else, and anyone treating an area for the first time.
- The mindset — Pick the product for the area, review it, then adjust or dissolve.
What the trials showed
Bellafill
Bellafill's long-term study tracked lumps, not looks. Of 1,008 people enrolled, 871 were followed for five years and checked for granulomas, a type of inflammatory lump. Biopsy confirmed one in 1.7% of people, and 0.9% still had an unresolved lump at the end. Satisfaction stayed high. Marketing that calls Bellafill the only FDA-approved filler that lasts 5 years is a framing of this safety study, not a five-year result on how the skin looked.
Bellafill also worked on acne scars. In its scar trial, 64% of treated people improved by at least two points on a four-point scar scale at six months, against 33% of controls. Side effects linked to treatment occurred in 9.8%.
Juvederm
Juvederm's results are reported as responder rates. For example, 86% of people treated in the cheeks with Voluma XC were still counted as improved at 6 months, falling to 67% at 24 months. A responder is anyone who improved by at least one grade, which is a low bar, and the company that ran the trials owns the scales.
The fine print
Bellafill
Bellafill. Polymethylmethacrylate microspheres, 30 to 50 microns across, suspended in bovine collagen with lidocaine. Approved in 2006 as ArteFill for nasolabial folds, with pre-treatment skin testing for bovine collagen sensitivity required. In December 2014 the approval added moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over 21.
Juvederm
Juvederm. Cross-linked hyaluronic acid with 0.3% lidocaine. Concentrations by product: Volbella XC 15 mg/mL, Vollure XC 17.5, Voluma XC 20, Ultra XC and Ultra Plus XC 24, Volux XC 25. Approvals are area by area: facial wrinkles and folds (Ultra XC, Ultra Plus XC, Vollure XC); lips (Ultra XC, Volbella XC); cheeks and chin (Voluma XC, which added a temple use in 2023); jawline (Volux XC); under-eye hollows (Volbella XC); cheek smoothness and, since 2026, neck lines (Skinvive).
More photographs
Juvederm
Common questions
Questions Patients Ask
Is Bellafill really permanent?
The part that matters is. The bovine collagen carrier is resorbed over roughly one to three months, but the polymethylmethacrylate microspheres are non-resorbable and stay in place. The FDA describes them as particles that are not absorbed by the body, and the published literature on permanent fillers records no documented spontaneous or induced degradation. Juvederm products, by contrast, are broken down over months to a couple of years.
Can Bellafill be dissolved if I do not like it?
No. Hyaluronidase only breaks down hyaluronic acid, so it works on Juvederm and does nothing to an acrylic polymer. Steroid injections are used for inflammatory lumps, but they treat the reaction rather than removing the material. The only definitive option is surgical excision.
Why does Bellafill need a skin test?
Because the microspheres are suspended in cow collagen, and some people are sensitive to it. Its 2006 approval required pre-treatment skin testing for bovine collagen sensitivity before injection. Juvederm needs no skin test — its hyaluronic acid is made by bacterial fermentation, not taken from an animal. Ask your clinic how far in advance they place the test and when they read it.
Does Bellafill last five years?
The five-year study measured granulomas and patient satisfaction, not appearance. It enrolled 1,008 people, of whom 871 completed five years; biopsy-confirmed granuloma occurred in 1.7% and 0.9% still had an unresolved granuloma at the end. There was no blinded wrinkle score and no control group at five years, so "satisfaction stayed high at five years" is not the same claim as "the correction lasts five years."
Which one is better for acne scars?
Bellafill is the one with an approval for it: moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over 21, added in 2014. In that trial, 64% of treated people reached at least a two-point improvement across at least half their scars at six months, against 33% on saline. No Juvederm product carries an acne scar indication, so using one for scars is off-label — which is legal, but untested at that level.
How much hyaluronidase does it take to dissolve Juvederm?
More than people expect, and it varies within the family. Expert guidance on emergencies notes that the Vycross-family products need hundreds of units to dissolve 1 cc, and a laboratory comparison found Juvederm among the most resistant products tested, requiring 300 units for degradation within an hour. Reversible does not mean instant, and in the US this use of the enzyme is off-label.
What are the risks that are specific to a permanent filler?
Late reactions do not have a cut-off. Granulomas — persistent inflammatory lumps — were confirmed by biopsy in 1.7% of the five-year surveillance group, and the published record includes a cheek abscess that had drained for three years and, on excision, contained polymethylmethacrylate microspheres. The material also cannot be dissolved in an emergency, which is why Bellafill's approval documents note a post-market report of blindness after periorbital injection, an area it is not approved for.
Has anyone compared Bellafill and Juvederm head to head?
No. Every figure on this page comes from a separate trial with its own scale, its own comparator and its own endpoint — Bellafill against bovine collagen in 2006 and against saline in 2014, the Juvederm products mostly against no treatment. Numbers from different trials cannot be lined up to say one product beat the other.
Safety to keep in mind
Off-label use. Injecting a product outside its approved area is legal and common. Voluma XC in the temples is an exception: the FDA required an approved device-specific training programme for that use. Using hyaluronidase to dissolve filler is off-label in the US as well.