When it comes to choosing a filler, knowing it’s made with hyaluronic acid only tells you so much. New York dermatologist Michelle Henry, MD, compares it to knowing a car is made of steel. What really matters is how it’s constructed and what it can do.
On the latest episode of The Beauty Authority, Dr. Henry explains the differences between fillers as two new additions to the Belotero family make their U.S. debut. Belotero Volume (+) is designed for the cheeks and midface, while Belotero Intense (+) is intended for the lips. Both have been used abroad for years, but they’re new options for American patients.
In our conversation ahead, Dr. Henry shares what makes them different, how she approaches facial balancing and why the number of syringes shouldn’t be the starting point for a treatment plan. Press play to watch, or keep scrolling for the takeaways.
What Makes These Fillers Different?
Both new fillers use Belotero’s cohesive polydensified matrix (CPM) technology, a method of cross-linking hyaluronic acid that allows the gel to hold together while remaining flexible. Dr. Henry says that construction is what gives each filler its distinct characteristics.
Volume is meant for deeper placement, while Intense is built for the lips. That flexibility is especially important there.
“What moves more than our lips?” Dr. Henry asks.
For the cheeks, she sees an especially timely application among patients experiencing facial volume loss following significant weight loss, including those taking GLP-1 medications. As more patients seek treatment for facial changes after weight loss, she says restoring volume in the right areas can make a meaningful difference.
The Goal Isn’t to Fill Every Hollow
Dr. Henry says her approach to injections has changed as doctors have developed a better understanding of facial anatomy and how fillers interact with tissue.
“I’ve started to call it precision anchoring instead of filling,” she says.
Rather than treating every hollow as a place that needs more product, she looks at what’s happening beneath the skin. Is the patient losing fat, bone or both? Would a deeper injection provide better support? Could treating one area improve the appearance of another?
She also rejects the idea that an aging face is simply a deflated balloon that needs to be reinflated. Her approach considers the underlying changes before deciding where, and how much, to inject.
You Don’t Necessarily Need to Dissolve Your Old Filler
If you’ve had filler before, trying something new doesn’t automatically mean starting over. Dr. Henry says the decision depends on what’s already been injected and whether it works with the new treatment plan.
“Do we need to erase this?” she asks. “Or is there something that we can build upon?”
In some cases, existing filler can remain in place. In others, dissolving it may be the better option. She also points out that treating a different area can sometimes change the way skin drapes over the face, improving concerns that patients initially thought needed to be addressed directly.
Stop Counting Syringes
One mistake Dr. Henry frequently encounters is patients arriving with a predetermined number of syringes in mind.
“You’re coming in to pay for a result,” she says.
She would rather know what a patient wants to improve and then determine how to achieve it. That sometimes means placing filler somewhere other than where the patient expected.
Her example: a perfectly filled lip can look out of place if the surrounding face tells a different story. She’d prefer to partially correct the lips and address another area than spend an entire budget perfecting one feature.
It’s also why she encourages patients to choose an injector who considers the entire face, not just the area being treated.
What to Ask Before Getting Filler
With more filler options available, Dr. Henry says patients should feel comfortable asking why their injector is recommending a particular product.
Beyond proper licensing and a strong understanding of anatomy, she says an experienced injector should know how to recognize and manage complications.
“Even in the best hands, complications can happen,” she says.
Her advice is to ask what could go wrong, how complications would be handled and why a particular filler makes sense for your face. An injector should be able to explain those decisions clearly, including why one gel may be better suited to a certain area than another.
As Dr. Henry puts it, every gel has “a different personality and different characteristics.” Knowing which one belongs where is part of what makes a skilled injector.
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