Bellafill is a tremendous option for under the bags under the eyes that seem to inevitably develop as we get older.  Like all fillers, it must be done with precision and care.  One patient who had fat grafting in the remote past and who has also had many different fillers said that, in her view, “a syringe of filler, no matter what it is; fat, Juvederm or Bellafill, is like a pencil.  You can put a pencil in an artist’s hand or a 5 year old’s hand and you will get two different things.
Many surgeons do not recommend Bellafill since they are familiar with fat transfers and they have their nurse provider inject the fillers that are offered at their office.
Bellafill will last a long time.  The safety data is the best of all the fillers and shows that it will last at least 5 years.  We cannot technically say that it is permanent, since we do not have studies that go past 5 years but I have seen patients 11 years after their injection and it is still working well.  Bellafill is also far more predictable than fat grafting.  I abandoned fat grafting a few years ago because Bellafill was so much better.
Here is a video of a result 5 years after Bellafill was used for lower eyelid bags.