Question 1

What is Belotero?

Accepted Answer

Belotero Balance is an injectable hyaluronic acid (HA) filler that’s FDA-approved to smooth moderate to severe facial wrinkles and folds, such as nasolabial folds.

It's similar to other hyaluronic acid-based fillers, like Juvéderm and Restylane, but Belotero Balance is ultra lightweight and easy to layer, so it can be injected into very fine lines without creating lumps or bumps. It’s commonly used to minimize etched-in lip lines, crow’s feet, smile lines, and marionette lines.

“Belotero is a softer filler that’s great for superficial creases, especially lip lines [aka smoker’s lines] and chin wrinkling,” says Dr. Dilip Madnani, a facial plastic surgeon in New York City. “It’s also used off-label to soften the under-eye tear troughs.”

Some providers use it in conjunction with Botox, to smooth deep glabellar lines (frown lines).

It can also be used to subtly plump lips, though most injectors prefer Juvéderm Ultra or Restylane Kysse.

It’s not the go-to solution for contouring the facial framework or building up the cheekbones. “Areas such as the cheeks usually require a more robust filler,” explains Dr. Madnani, “so Belotero can be combined with other fillers for optimal results.”

Question 2

What are the pros and cons of Belotero?

Accepted Answer

Pros

Results can last up to a year—longer than those of many hyaluronic acid–based injectable fillers.
When it’s injected by an experienced provider, Belotero is very natural looking.
There's little to no recovery time following Belotero injections, and side effects generally include only mild bruising and swelling of the treated area.
It can seamlessly smooth thin-skinned areas, like the under eyes, and it isn’t associated with excess swelling or the Tyndall effect (a bluish tint associated with some other types of HA fillers), which makes it one of the more natural-looking filler options.
The procedure isn’t considered painful—especially if your doctor first numbs the area with topical lidocaine cream.
If you aren’t satisfied with your results or you have a complication, an enzyme called hyaluronidase can be injected into the area in order to dissolve the hyaluronic acid.

Cons

As with all hyaluronic acid–based fillers, results are temporary.
Rarely, people experience complications, including infection and vascular occlusion, which can lead to skin necrosis (death of skin cells) and blindness.
Lumps or irregular texture can sometimes occur, although these issues can usually be massaged away.
Belotero isn’t a thick or sturdy gel, so it’s not the best option for areas that need a lot of shape or sculpting, like the cheeks, jawlines, and temples.

Question 3

How much does Belotero cost?

Accepted Answer

Your Belotero cost will depend on your provider’s office location, their level of experience, and how much filler you need. Most practices charge by the syringe, typically charging $400–$600 per syringe in the U.S.

This is an elective cosmetic treatment that’s not covered by insurance.

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This is an elective cosmetic treatment that’s not covered by insurance.

Question 4

Belotero before and after pictures

Accepted Answer

The Belotero photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

What happens during a Belotero treatment?

Accepted Answer

First, your healthcare provider will take a detailed medical history, ask about prior cosmetic treatments, and note any allergies you have along with the drugs and supplements you’re currently taking.
Your injector should disclose the potential risks and side effects associated with Belotero injections and have you sign a consent form.
You’ll discuss your treatment plan and goals and why Belotero is the best choice for you and your particular concerns.
Your injector (or their medical assistant) will thoroughly clean your skin around the treatment area with an antiseptic solution. They may mark the areas they intend to treat.
Though Belotero does contain a small amount of lidocaine, most injectors also apply numbing cream; it has to sit on skin for at least 30 minutes to take effect.
They’ll inject Belotero using a fine needle or cannula.
After each injection, they’ll gently massage the filler, to help distribute it so it sits more evenly.
Your provider will review aftercare instructions and lifestyle restrictions (i.e. no exercise, alcohol, excessive heat, or NSAIDS for up to 48 hours post-shot).

The entire process typically takes 30-60 minutes.

Question 6

Is Belotero safe? What are the risks and side effects?

Accepted Answer

Belotero is FDA-approved and safe for use when injected by a trained medical professional with extensive experience and an intimate knowledge of facial anatomy.

Even in qualified hands, Belotero, like all dermal fillers and cosmetic treatments, can cause temporary and long-term complications.

The risks and side effects of Belotero include:

Bruising
Swelling
Infection
Tenderness
Lumps and bumps
Asymmetry
Vascular occlusion (accidental injection into a blood vessel, which can rarely lead to necrosis, blindness, and stroke)

Before getting HA filler injections, make sure your injector has ample hyaluronidase on hand in case of emergency. This enzyme-based shot can quickly dissolve hyaluronic acid fillers like Belotero. It can also be used to fix less dire mistakes, effectively melting lumps and correcting overfilled areas.

Ask your injector how to reach them (or someone on their team) after hours, in case you have questions or problems once the office closes.

Related: A Quick Shot of Under-Eye Filler Can Do Away With Dark Circles. What's the Catch?

Question 7

What can you expect after Belotero treatment?

Accepted Answer

There’s little to no downtime after a Belotero treatment. “You may experience some bruising and swelling at the injection sites for a few days,” says Dr. Madnani, but most people can go right back to work and resume their daily activities immediately after the procedure.

Avoid these things for at least 24 hours afterward, to help reduce swelling:

intense exercise
heat and sun exposure
alcohol
excess salt
nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin
lying face-down

Dr. Kristin Tarbet, an oculoplastic surgeon in Bellevue, Washington, suggests taking an antihistamine (like Claritin) to combat swelling. If any symptoms persist after seven days, call your provider.

Question 8

How soon will you see Belotero results?

Accepted Answer

You’ll notice increased volume immediately, but you won’t see your final results for one to two weeks, after any swelling has completely gone down.

Dr. Madnani has all his patients return for a follow-up appointment after two weeks, to evaluate their results. In rare cases, he makes adjustments at that point.

Belotero is often paired with other skin-rejuvenation treatments. “A combination approach will give the most improvement,” says West Hollywood, California, dermatologic surgeon Dr. Jason Emer. For example, he likes to combine Belotero with a laser treatment or microneedling with PRP, to improve the area under the eyes.

Related: The Treatments and Ingredients Actually Proven to Reduce Wrinkles

Question 9

How long do results last?

Accepted Answer

Belotero filler usually lasts up to a year, although it tends not to last as long in areas that move a lot—and everyone metabolizes fillers differently.

Question 10

Belotero vs. Juvéderm: What’s the difference?

Accepted Answer

Juvéderm and Restylane are the most popular and widely used hyaluronic acid fillers in dermatology and plastic surgery practices. They’re similar to Belotero, but the formulations vary in myriad ways, including HA concentrations and molecular weight, specific cross-linking technologies, and more.

Differences in chemistry give fillers their unique properties, like viscosity, elasticity, cohesivity, and longevity. These properties determine the filler’s effects as well as appropriate placement and usage.

When comparing Belotero and Juvéderm, there are some key similarities and differences to be aware of.

Similarities

Both Belotero and Juvéderm are made from hyaluronic acid, a water-binding gel.
They offer temporary effects and dissolve on their own over time.
They can be used to smooth creases, add volume, and camouflage hollows.
Both can be reversed or adjusted with hyaluronidase.

Differences

Juvéderm is a family of HA fillers and each individual formulation has unique qualities and a specific purpose. (Juvéderm Voluma is a structural filler used for cheek augmentation; Volux is more robust and indicated for jawlines; Volbella is thinner and works well in lips.) There is only one Belotero filler currently FDA-approved in the US, and that’s Belotero Balance. (Other formulations, like Belotero Volume and Belotero Intense, are in use elsewhere in the world.)
Belotero is softer and more fluid than Juvéderm fillers, making it most appropriate for blurring creases (lip lines, crow’s feet, smile lines) and obscuring mild under-eye hollows.
Belotero can be injected superficially and look imperceptible whereas many Juvéderm products require deeper placement (well below the dermis).
Across the board, Juvéderm fillers tend to attract more water and cause more swelling than Belotero, which is why many injectors avoid placing Juvéderm under the eyes.
Juvéderm products generally last longer than Belotero, due to their cross-linking. Many patients see this as a good thing (fewer touch-ups), however, Juvéderm’s resilience can also make it difficult to dissolve if problems arise.
Certain Juvéderm fillers have been shown to have a higher rate of lumps and delayed inflammatory reactions than Belotero.

Question 11

What are the alternatives to Belotero?

Accepted Answer

Along with Juvéderm, Restylane, and RHA hyaluronic acid-based dermal fillers, there are a number of different injectable volumizers available, made from other materials. You and your doctor may choose one over the other, depending on your facial anatomy and concerns.

Radiesse contains calcium hydroxylapatite, a mineral-like compound that occurs naturally in human bones. It’s most commonly used for nasolabial folds, marionette lines, and frown lines as well as to plump sunken-looking cheeks. Radiesse can also be used for hand rejuvenation. It’s irreversible and typically lasts longer than hyaluronic acid fillers. It’s not recommended for use in the lips or tear troughs.
Sculptra, made of poly-l-lactic acid, is a semipermanent synthetic product that spurs the body to produce more collagen over a period of a few months. Three monthly treatments are typically needed for best results, and you may need additional touch-ups. Sculptra is typically used on the lower half of the face and in the temples, but should never be placed in the lips or under the eyes.
Bellafill contains bovine collagen and polymethyl methacrylate microspheres (PMMA), which stimulate collagen production over time. It’s a semipermanent filler, usually used to treat moderate to severe wrinkles and even out pitted scars. Like Sculptra and Radiesse, it’s not recommended for the lips or tear troughs. The major drawbacks are that several treatments may be needed, it takes months to work, it may show or be palpable under the skin, and it is not reversible. Due to its bovine component, Bellafill requires an allergy test before use.

BELOTERO

Dilip D. Madnani, MD, FACS

Lesley Rotchford

Dilip D. Madnani, MD, FACS

Lesley Rotchford

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	Belotero nonsurgical	Juvéderm nonsurgical	Restylane nonsurgical	RHA Collection Fillers nonsurgical	Radiesse nonsurgical	Sculptra nonsurgical	Bellafill nonsurgical
Worth It Rating	67%	91%	86%	87%	64%	83%	50%
Average Cost	$879	$950	$1168	$920	$1371	$1744	$3235
Downtime	No downtime	No downtime	No downtime	No downtime	Minimal downtime	Minimal downtime	No downtime
Anesthesia	No anesthesia	Topical anesthesia	Topical anesthesia	Topical numbing cream	Topical anesthesia	Topical anesthesia	No anesthesia

Dilip D. Madnani, MD, FACS

Lesley Rotchford

Dilip D. Madnani, MD, FACS

Lesley Rotchford

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