Belotero® Intense is a cross-linked hyaluronic acid (HA) dermal filler designed by Merz Aesthetics to treat deep facial wrinkles and restore structural volume. Thanks to its unique CPM® (Cohesive Polydensified Matrix) technology, it integrates smoothly into the skin while offering structural support in dynamic areas such as nasolabial folds and marionette lines. This article provides a complete clinical overview for aesthetic medicine professionals.
Product Overview and Composition
| Feature | Specification |
|---|---|
| HA Concentration | 25.5 mg/mL cross-linked, non-animal stabilized HA |
| Technology | CPM® – Matrix with zones of varying density for structural and elastic behavior |
| Injection Depth | Deep dermis to subdermal plane; supraperiosteal when required |
| Duration | 9 to 12 months, up to 18 months in some patients |
| Indications | Nasolabial folds, marionette lines, chin and jawline contouring, structural lip enhancement |
Understanding CPM® Technology
CPM® technology enables Belotero® Intense to blend uniformly into tissues, adapting to facial dynamics while minimizing risks like product migration or lump formation. It is formulated with zones of different viscoelasticity—dense areas provide lift and structure, while softer regions allow seamless integration into tissue.
This balance gives injectors greater precision and patients more natural outcomes, even in areas with constant movement.
Belotero® Range Comparison
| Product | Viscosity | Primary Use | Injection Depth | Duration |
|---|---|---|---|---|
| Soft | Very low | Superficial fine lines | Superficial dermis | 6–9 months |
| Balance | Moderate | Moderate folds, lips | Mid dermis | 9–12 months |
| Intense | High | Deep wrinkles, contouring | Deep dermis / subdermis | 9–12 months |
| Volume | Very high | Cheek and temple volumization | Subdermal / periosteal | Up to 18 months |
Intense is ideal for foundational support and can be layered beneath Soft or Balance for surface refinements.
Clinical Performance
Randomized Controlled Trial
A 48-week clinical trial comparing Belotero® Intense to a comparable deep filler (Perlane®) showed greater wrinkle reduction and patient satisfaction with Belotero. Measurable improvements included greater depth reduction in nasolabial folds and higher aesthetic improvement ratings.
Open-Label Study
In a multicenter open-label study of 149 subjects, Belotero® Intense used alone or with Balance showed:
- Significant wrinkle severity reduction by week 2 and sustained through week 12
- Over 80% rated the aesthetic result as “good” or “excellent”
- Very low incidence of adverse effects, with most resolving in under two weeks
Injection Protocols and Safety
Technique Recommendations
- Use a 27G needle or cannula
- Inject slowly with minimal pressure
- Recommended techniques include linear threading or bolus injections in deep dermis or subcutaneous layers
- Aspirate before injecting in high-risk vascular zones
Safety Guidelines
- Maintain maximum volume below 6 mL per treatment area per year
- Avoid use in areas with infection, inflammation, or autoimmune concerns
- Hyaluronidase may be used in case of vascular occlusion or overcorrection
Clinical Indications
Belotero® Intense is best suited for:
- Nasolabial folds
- Marionette lines
- Chin projection and definition
- Jawline contouring
- Structural support for lips when higher viscosity is needed
Its high cohesivity allows for durable placement without sacrificing facial movement or texture.
Patient Benefits
- Long-lasting volume and wrinkle correction
- Smooth tissue integration with natural feel
- Minimal downtime and swelling
- Retained facial expressiveness
- Clinically proven safety and efficacy
Frequently Asked Questions
Can Belotero® Intense be used for lips?
Yes, particularly when volume and definition are needed. It provides firm yet natural results when used with conservative technique.
How does it compare to Belotero® Volume?
Volume is intended for large-scale volumization (e.g., cheeks, temples), while Intense is better for line correction and defined contouring.
Is it reversible?
Yes. As with other HA fillers, Belotero® Intense can be dissolved using hyaluronidase if necessary.
Is layering possible with other Belotero® fillers?
Absolutely. Intense is often layered beneath Balance or Soft to create multi-plane correction.
Belotero® Intense is a powerful tool for aesthetic physicians seeking reliable, long-lasting correction of deep wrinkles and facial contours. Its unique formulation, based on CPM® technology, allows it to integrate harmoniously into tissue while providing the necessary lift and definition. Supported by clinical trials and widespread practitioner use, Belotero® Intense represents a gold standard in non-surgical facial rejuvenation.
References
Merz Aesthetics – Product Overview and Clinical Guidelines
https://www.merzaesthetics.com
Merz Pharmaceuticals – Belotero® Intense Instructions for Use (IFU)
https://www.ifu.merzaesthetics.com
U.S. Food & Drug Administration – Summary of Safety and Effectiveness Data (P090016)
https://www.accessdata.fda.gov/cdrh_docs/pdf9/P090016c.pdf
Clinical Study: Performance and Tolerability of Belotero Intense
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5021061