the doctor inject a filler into the woman`s lip

Belotero is a brand of dermal fillers produced by Merz Pharma, a pharmaceutical company headquartered in Frankfurt, Germany. Belotero fillers were first introduced to the market in 2005. They have gained popularity among medical professionals for their unique properties and effectiveness in treating fine lines and wrinkles. 

In this article, we will explore the various applications and benefits of Belotero products, and the potential risks and side effects that medical professionals must know.

Definition of Belotero Balance

Before diving into the science behind the product, its administration, and its advantages, we need to answer a few questions – what is Belotero? and what is it made from?

Belotero is a dermal filler that treats wrinkles and provides a non-invasive lifting treatment. It’s based on hyaluronic acid, like most modern cosmetic dermal fillers. Belotero is made from a non-animal, biodegradable form of hyaluronic acid specifically designed to integrate with the skin’s tissue for a more natural-looking result.

One of the unique features of Belotero fillers is their monophasic structure. This means the gel is uniform and homogeneous, making it less likely to cause lumps or bumps in the skin near the injection site.

The smooth consistency of the filler also allows for easier injection and more precise placement, crucial for achieving the natural facelift. It comes in various formulations with varying degrees of elasticity and viscosity, allowing customized treatment options depending on the patient’s needs.

The Science Behind the Belotero Injection

As previously mentioned, Belotero is made from hyaluronic acid, a naturally occurring substance in the human body that keeps the skin hydrated and plump.

Hyaluronic acid is a complex polysaccharide composed of repeating disaccharide units of N-acetylglucosamine and glucuronic acid. It is a significant component of the skin’s extracellular matrix and critical in maintaining its structure and function.

The hyaluronic acid in Belotero Balance is produced using a proprietary technology called Cohesive Polydensified Matrix (CPM). This creates a monophasic uniform gel with a smooth homogeneous consistency. This unique manufacturing process gives greater control over the size and structure of the hyaluronic acid molecules, resulting in a more predictable and consistent product.

Once injected into the skin, the Belotero lip filler integrates with the skin’s tissue, hydrating and restoring volume to the treated area. The hyaluronic acid in the filler attracts and binds to water molecules, creating a cushioning effect that smooths out the skin’s surface and fine wrinkles. 

Several studies have investigated the safety and efficacy of Belotero dermal fillers. One study published in the Journal of Clinical and Aesthetic Dermatology found that the fillers effectively treated nasolabial folds, and had a high patient satisfaction rate. Another study published in the Journal of Drugs in Dermatology demonstrated the safety and efficacy of Belotero in treating tear trough deformities.

Indications for Belotero fillers

Like other dermal fillers, Belotero is most commonly indicated for treating various aesthetic concerns. Specifically, Belotero can be used to:

  • Enhance lips: One of the most frequent uses for Belotero is lip enhancement. This includes improving lip volume, shape, and contour; and correcting vertical lip lines.
  • Treat nasolabial folds: These deep lines extend from the nose to the corners of the mouth.
  • Correct marionette lines: Belotero can improve facial volume and fill in lines extending from the corners of the mouth to the chin. 
  • Treat tear-trough deformities: Dark circles and hollows that form under the eyes, giving a tired appearance to the patient. Applying Belotero to that area provides a more youthful appearance.
  • Enhance cheek volume and contour: Belotero can add volume to the cheeks and improve their contour, creating a more youthful and vibrant appearance.

In addition to these specific indications, Belotero products can also be used for general facial rejuvenation and improving skin elasticity. The precise application of dermal fillers depends on the individual patient and their unique aesthetic concerns.

Techniques for Administering Belotero Injections

Belotero is injected into the treatment area using a small needle or cannula. The exact injection technique depends on the treated area and the desired results. The three most common ways of administering Belotero are linear-threatening, tunneling, and serial puncture injections.

Linear-threading technique: The linear-threading method involves injecting small amounts of Belotero along a line or wrinkle. The medical professional will use a needle to make a series of small injections along the line, which will help smooth and fill in the wrinkle. This technique often treats fine lines around the mouth and eyes.

Tunneling technique: The tunneling technique starts by using the needle to create a small tunnel in the skin. Then, Belotero is administered into the tunnel, filling the gap. The tunneling technique often treats larger areas, such as the cheeks or jawline.

Serial puncture injections: Serial puncture injections, as the name implies, involve making a series of small injections in the treated area. This way, the filler is distributed evenly, creating a smooth, natural-looking result. This technique is often used to treat nasolabial folds.

Each technique has advantages and disadvantages: the method chosen depends on the treatment area and the patient’s desired outcome. 

Advantages of Belotero fillers

Belotero has gained popularity mainly due to its ability to provide patients with natural-looking results thanks to the hyaluronic acid it is based on.

It’s also a remarkably versatile product. We can use Belotero for lips, chin, and other areas requiring more volume: the results last up to six months or longer, depending on the treated area and the patient’s metabolism.

Patients often choose to get Belotero as it’s a quick procedure that takes just 30 minutes. Additionally, patients who refrain from surgeries regarding facial rejuvenation tend to choose dermal fillers due to speedy recovery and low risk of side effects.

Belotero is also a customizable treatment. Depending on the patient’s personal goals, the treatment can be adjusted to suit their requests.

Adverse Effects and Precautions

Like all medical treatments, dermal fillers may cause unwanted effects in certain situations. Belotero side effects are mostly mild and temporary, lasting no more than a few days. These include:

  • Swelling
  • Redness
  • Bruising
  • Pain
  • Itching
  • Tenderness

Less common side effects include granulomas (lumps under the skin) and severe allergic reactions in very rare cases. All in all, adverse reactions to Belotero are rare and occur in less than 1% of patients.

Not everyone is a candidate for dermal fillers, including Belotero. Individuals with a history of severe allergies, autoimmune diseases, or bleeding disorders may not be suitable candidates for dermal fillers. Additionally, pregnant or breastfeeding women should avoid dermal fillers until after breastfeeding.

To ensure the patient’s safety, asking them to disclose any medical history, including medications they’re currently taking, is recommended. After the treatment, the patient should avoid caffeine and alcohol for several days to reduce the risk of bruising. This also applies to strenuous physical activities, especially during the first 24 hours.


With non-invasive and non-surgical procedures becoming more popular over traditional plastic surgeries, products like Belotero are crucial. With many glowing Belotero reviews from satisfied patients and medical professionals, it’s clear these dermal fillers have proven their potential and continue to be highly requested.


How much does one syringe of Belotero cost?

Belotero is in the medium range, price-wise. Depending on the quantity and type of filler, the price can be anywhere between $119 and $849 per unit.

How long does Belotero filler last?

Typically, the patient will see the results of their Belotero treatment for up to six months.

Which is better, Juvederm or Belotero?

Both dermal fillers have their specific uses and advantages. Juvederm is mainly applied when treating deeper facial lines, while Belotero fillers are primarily used for fine lines.


Belotero intended use/indications, U.S Food and Drug Administration

A Randomized, Blinded, Controlled, Multicenter Study of the Safety and Effectiveness of Dermal Filler, Belotero®, After Mid-to-Deep Dermal Implantation for Correction of Moderate to Severe Facial Wrinkles

Jessica Gandy, Dina Bierman, Christopher Zachary, Granulomatous reaction to Belotero Balance: A case study, 2017 Feb 28

Adri D Prasetyo, Welf Prager, Mark G Rubin, Ernesto A Moretti, and  Andreas Nikolis, Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation: a literature review, 2016 Sep 8

Patrick Micheels , Didier Sarazin, Stéphanie Besse, Hema Sundaram, Timothy C Flynn,  A blanching technique for intradermal injection of the hyaluronic acid Belotero, 2013 Oct