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The Belotero Family


Summary and Key Features

  • Belotero is a commonly used group of hyaluronic acid fillers.

  • It is cross-linked with 1,4-butanediol diglycidyl ether (BDDE), forming a cohesive and polydensified matrix (CPM).

  • There are several products of various thicknesses in the Belotero line, some with and others without lidocaine. These include Belotero Volume, Intense, Balance, and Soft.

  • Good clinical data (e.g., data from at least one randomized controlled trial) have been published for Belotero Balance (formerly Belotero Basic) and Belotero Volume.

  • In a 6-month study of nasolabial folds filling. Belotero Balance demonstrates at least a one-grade improvement at the end of the study.

  • After treatment of the cheeks with Belotero Volume, about one half of the patients still showed at least a one-grade improvement after 18 months.

  • The Belotero family of products has a good safety profile.

Acknowledgment

Martina Kerscher, Heike Buntrock, and Vanessa Hartmann contributed to the chapter of an earlier edition of the book that served as a basis for this chapter.

Introduction

Hyaluronic acid (HA)–based dermal fillers are currently the most popular, nonpermanent injectable materials available for the correction of age-related changes of the face for wrinkles, folds, and volume loss. HA fillers derive from bacterial fermentation from a specific Streptococcus strain ( Streptococcus equi ), a bacterium nonpathogenic in humans. Because natural HA does not persist in tissues for more than 24 hours, it needs to be chemically stabilized by cross-linking techniques. Most hyaluronic-based fillers, such as the Belotero brand, are stabilized by 1,4-butanediol diglycidyl ether (BDDE).

Differentiation of Hyaluronic Acid Fillers

How do we differentiate HA fillers? Outside the United States, a multitude of injectable fillers, specifically HA fillers, are available. However, most of them are not based on good randomized controlled trials (RCTs). Without good-quality RCTs, it is difficult to give guidance on the efficacy and safety for these products. The Belotero family discussed in this chapter has several well-done RCTs.

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