What is the reason that some doctors do not offer Belotero as a filler option?

There are several great, board certified plastic surgeons in my area that do not offer this filler. I have pretty much decided that I would like to use Belotero under my eyes, as some of the other fillers can cause the Tyndall effect. I am trying to cover the bluish color under my eyes and after having Juvederm and Restylane in my lips, I see that blue tint. Is there a reason more doctors do not offer Belotero? Thank you for your time!

Doctor Answers 8

Doctors typically inject the fillers that they have the best experience with

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This is a very interesting question you ask, and actually, there is more to it than meets the eye.  I'm not sure that you can ever get a truly black or white answer to it, but it is something that I find intriguing so I'll give you my own personal insights.  I think it touches to some degree on why there are differences in opinion and treatment approach in general among individual doctors.  In short, doctors will typically offer those treatments - fillers and others - that in their own hands and in their experience, whether that be in training or their own clinical experience, deliver the most reliable, reproducible, safe, and effective results.  If a doctor finds that for the treatments (s)he offers, one filler provides the results that s(he) and his/her patients find optimal, then that generally is what the doctor will offer, and there may be little motivation to find new or alternative treatments.  On the other hand, some doctors are always looking for new things, and even if the differences between something new and something that has been around for awhile are subtle, if the new product can deliver even slightly better results, those doctors who are early adopters will learn to exploit those subtle differences and often will get results that are better than what they could have gotten with the products or treatments previously available.  This gets into not only the specific technical or scientific differences between the individual products and how they're made, but also the differences in temperament and clinical approach between physicians and how and why they make the clinical decisions they do.  Some doctors prefer a more conservative approach, and while they may not achieve the most dramatic results or treat the widest spectrum of conditions, they will be able to deliver reliable, consistent results in the treatments they do offer.  Those doctors may be among those who do not offer Belotero, as it is one of the newest fillers in the US, along with Voluma.  Other doctors are more comfortable pushing envelopes, learning about new things as they hit the market, and gaining the first experience with the newest products.  It will be those doctors that are most likely to use Belotero.  Lastly, you will find that some doctors are loyal to a particular manufacturer over others, and thus, they may offer only those fillers and other products that are supplied by their one favored manufacturer.  Those doctors may receive volume discounts or certain other financial incentives in exchange for such loyalty and exclusivity.  Personally, I dislike this last approach as I find all of the fillers and toxins to have their own unique qualities and benefits, and to not offer a range of products to my patients is potentially excluding some of them from the optimal results that they could achieve.  As a filler, Belotero has proven itself, and I can personally vouch for that as I have extensive experience with it, and I find it to be very reliable and effective in the right patients and for the right indications.  As you allude to, one of its biggest benefits is because of the way it refracts light, Belotero rarely, if ever, produces the Tyndall effect.  Thus, if a doctor is not using it in his or her practice it likely has more to do with one of the aforementioned reasons than the performance of the filler itself.  If you are interested in having treatment with Belotero I think you should feel confident in finding a board certified physician with experience in injecting Belotero and scheduling a consultation to explore the potential benefits that Belotero injection can offer you.  Good luck.

San Diego Plastic Surgeon

Choice of Filler

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The choice of what filler a particular practice offers is based on experience and knowledge. If the doctor responsible for ordering the fillers has not seen anyone with the Tyndall effect, then they probably have not researched which filler has less tendency to produce it. This may be that he/she does not see the patients back or does not inject superficially. You are right; if you need superficial filler injection, Belotero is the least likely to cause the Tyndall effect. That is, in fact, one of the main reasons I use Belotero, the other being that it absorbs minimal water so you get less swelling in areas like around the eyes. Choose an Expert Injector.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Belotero As A Filler Option

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Ultimately, the choices of fillers offered by a specific practice comes down to the person preference of the injectors. In discussing filler options with your injectors most of them will let you know why they prefer one filler over the other. Personally, I mostly use Juvederm and Belotero depending on the area being injected, the depth of the wrinkles and folds, and the needs of the patient. I do prefer Belotero under the eyes in many of my clients for superficial corrections. If you go to the Belotero website you may be able to find an injector close to where you live. Best of luck.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

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Facial fillers - choices, choices, choices

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The type of facial filler used by a practitioner depends on the need of the patients served and the experience and comfort level of the treating physician. 

There is no need to have 3 types of HA fillers - Belotero, Restylane and Juvederm. Therefore, a doctor will choose one or 2 to stock the shelves and decides over time which product gives the best outcomes; which product has the best needle(s) and syringes that allow smooth injection; which product patients want in a geographic area depending on market needs and "buzz" among patients; and so much more.

It is very expensive to stock your office pharmacy with 10 different types of fillers. This is more of a problem when the practitioner has low volume. 

Having said that, we stock 6 different types of fillers in our offices because we usse them regularly and in large volume in a sophisticated marketplace in Buffalo Niagara. 

Belotero in Santa Monica

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The number of physicians comfortable with Belotero injections is steadily increasing, as it is a relatively newer filler when compared to Juvederm or Restylane. 


Dr. Karamanoukian 
Montana Avenue - Santa Monica

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Belotero is an excellent filler option

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Belotero is an excellent filer option for the area under the eyes.  Many patients want Belotero because they have had other doctors inject Restylane or Juvederm under the eyes and it has left them with too much swelling because of too much product placed or with the Tyndall effect and a bluish hue under the eyes.  Please consult a board certified dermatologist with a great deal of experience with Belotero and other cosmetic injections.


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The choice of available fillers in a practice depends of many factors, including injector comfort and experience with a particular product, the practice's relationship with the injectable companies, and who's responsible for product orders within the practice.  Belotero is a good, soft hyaluronic acid (HA) filler; it works well in tear troughs, shallow depressed scars, and etched-in fine lines.  It is less likely than some of the other fillers to cause the bluish Tyndall effect if injected superficially, though it can happen.  While it doesn't typically last for a long time (3-4 months in etched in lines or areas of high mobility), it will likely last longer in the relatively low-movement under-eye area.  Another good product for tear troughs is Restylane, which is a bit more stout and may be better for very deep lines or areas that need structural support. You may be well-served by finding an experienced provider who is comfortable with a variety of HA fillers, and discuss your preferences with him/ her.

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon

Belotero as a filler option

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Belotero is an excellent filler for under the eyes, but the use of Belotero is limited as it is too thin to use effectively in other spots. Restylane is also an excellent option for under the eyes for experienced and expert physician injectors.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.