Belotero and Juvederm are both hyaluronic acid fillers. Two things actually separate them. One is how many areas each is approved for. The other is where in the skin each product is meant to sit. Belotero is made by Merz and has four US products. Juvederm is made by Allergan Aesthetics and has seven.
Belotero's signature claim is that it can be placed finely and superficially. Merz's name for the manufacturing process is CPM, short for Cohesive Polydensified Matrix. That name appears nowhere in the FDA record. The record describes Belotero in plain chemical terms, as bacterially fermented hyaluronic acid crosslinked with BDDE. Belotero Balance's own approved wording is for the mid-to-deep dermis, not the surface.
Juvederm is a family, not a product, and each member has its own approval. Ultra XC and Ultra Plus XC for folds, Volbella XC for lips and under-eyes, Vollure XC for folds, Voluma XC for cheeks, chin and temples, Volux XC for jawline definition, Skinvive for skin smoothness of the cheeks and, since June 2026, neck lines. Nothing about one of them transfers to another.
No trial has compared a Belotero product with a Juvederm product. Belotero Balance's US pivotal was run against a bovine collagen filler in 2011. Every duration figure quoted for either brand comes from a separate trial with its own scale.
Belotero Soft and Belotero Hydro have no US approval and are not available here.
Two FDA approvals cover all seven: one from 2006 for the Ultra line, one from 2013 for everything else.
The lip approval belongs to Belotero Intense (+) Lidocaine and the mid-face approval to Belotero Volume (+) Lidocaine. Belotero Balance itself carries neither.
Voluma XC holds cheeks, chin and temples; Volux XC holds jawline definition; Volbella XC holds lips and the under-eye; Skinvive holds cheek skin smoothness and neck lines.
Vollure XC is 17.5, Voluma XC 20, Ultra XC and Ultra Plus XC 24. Skinvive's concentration is not stated in the FDA record.
The 2026 additions are placed differently: the lip product is approved for submucosal and subcutaneous placement, the mid-face product for deep subcutaneous or supraperiosteal placement.
Skinvive is injected intradermally. Voluma XC and Volux XC are approved for subcutaneous or supraperiosteal placement, which means deep, near or on the bone.
At 24 weeks, 55.1% of treated nasolabial folds had better than a one-point improvement. The under-eye trial was larger and longer: 150 people randomised, 80.6% responders at week 8 against 1.9% in an untreated control group, and 81.4% still responding at week 48.
Vollure XC ran 18 months, with responders falling from 93.2% at 6 months to about 58% at 12 and 18. Voluma XC ran 24 months, from 85.6% at 6 months to 67.1% at 24. Volbella XC's under-eye trial ran 12 months, 83.1% at month 3 and 73.4% at month 12.
The FDA documents describe the product as bacterially fermented hyaluronic acid crosslinked with BDDE, the same crosslinker used across the whole category.
The FDA documents describe Juvederm as crosslinked sodium hyaluronate made by Streptococcus equi fermentation.
Published emergency guidance says Vycross-family products can need hundreds of units to dissolve a single millilitre.
The reason this claim exists is that superficially placed hyaluronic acid can look bad. Gel sitting close to the surface scatters short-wavelength light. It then shows through thin skin as a blue-grey shadow, called the Tyndall effect. It is most visible under the eyes, where the skin is thinnest. There is no reliable published incidence figure for it. It is commonly reported, particularly in the under-eye area. But nobody has measured how often it happens.
A gel that behaves well close to the surface is therefore a real engineering goal, not a marketing invention. What is missing is independent proof that any one brand achieves it better than another. One independent laboratory study measured firmness across several gels, including Belotero Balance and Juvederm products. It found that simply adding lidocaine changed the measurements. One result was counterintuitive. Volbella XC, marketed as the softest and most delicate Juvederm, showed a higher elastic modulus than the other Allergan gels tested. Marketing language about softness and measured firmness are not the same thing.
This is where Belotero has its strongest published data. The under-eye approval came in September 2023, and the trial behind it followed 150 randomised people to 48 weeks, with 81.4% still meeting a one-grade improvement at the final visit against a delayed-treatment control group.
Four products carry a US under-eye approval: Juvederm Volbella XC, Restylane Eyelight, Belotero Balance (+) and RHA Redensity Eye and Eye Lido. Their figures come from separate trials using different manufacturer scales, so they cannot be ranked against each other, however tempting the numbers look side by side.
Belotero Volume (+) Lidocaine was approved for the mid-face in May 2026 and Belotero Intense (+) Lidocaine for lips in July 2026. Both are real, current FDA approvals. What is not yet available publicly is the detail of the trials behind them — the number of people, the follow-up length, the responder rates. Until that is published, there is no duration figure for either that anyone can quote responsibly.
No professional society publishes a current per-syringe price. The most recent official US average is a 2023 figure from the American Society of Plastic Surgeons: $715 for hyaluronic acid fillers, after which ASPS stopped publishing fees for minimally invasive procedures. That number is a surgeon or physician fee only, it excludes facility costs, it is per procedure rather than per syringe, and it pools ten or more different products across every part of the face — Belotero and several Juvederm products among them.
Neither Merz nor Allergan publishes a patient price.
Go to an emergency department or call 911 if any of these happen during or after a filler injection:
Sudden change or loss of vision in one or both eyes
Pain that is far worse than the procedure should reasonably cause
Skin that goes white or pale in a patch, then turns dusky, grey or mottled
Weakness on one side, a drooping face, slurred speech or confusion
These are the signs of filler entering a blood vessel. Published guidance treats a suspected eye event as a same-hour emergency and a suspected skin event as a same-day one. One caution about pain: in a survey of 52 experienced injectors, pain was mild or absent in 47% of the intravascular events they reported. Pain is not a reliable alarm, and its absence is not reassurance.
Swelling is still growing after the first few days instead of settling
A lump has not softened
Redness is spreading outward from an injection site
Tenderness, swelling or a new lump appears weeks or months later, which can mean a delayed inflammatory reaction or an infection
The filler looks like it has shifted out of place
None of these are emergencies, but none of them should be left alone either.