I was referred to Dr. Callahan by my primary doctor, Dr Callahan and staff are extremely nice, professional, and knowledgeable. I’ll return for eye care and have already recommended her to my family.
Chang Liu
Belotero Balance Under-Eye Filler with CPM Technology
What Clinical Evidence Shows About Belotero Balance
Belotero Balance has been studied in multicenter clinical trials specifically designed to evaluate its safety and effectiveness in the tear trough. The results provide a reliable picture of what most patients can expect from treatment.
In a multicenter clinical study, more than 80 percent of treated patients showed measurable improvement in tear trough hollowing after a single treatment session, as assessed by trained evaluators. The study focused on patients with mild to moderate hollowing, which is the ideal range for this type of injectable correction.
Results were measured at eight weeks after treatment, and patients who responded to treatment showed clear improvement in the depth and appearance of their under-eye hollows compared to those who received no treatment.
The most common side effect observed in clinical trials was injection-site swelling, which occurred in a small percentage of participants. Bruising, redness, and tenderness were also reported and resolved within the first two weeks for most patients.
No serious vision-threatening events were reported in the trial data. That said, vascular complications, though rare, are a known risk with any filler injection near the eyes, and this is addressed in more detail in the safety section below.
For most patients, results from Belotero Balance in the tear trough last approximately nine to twelve months. Because hyaluronic acid is gradually broken down by the body, the treatment is not permanent, and touch-up sessions can maintain the correction over time.
How long your results last depends on factors including your individual metabolism, the amount of product placed, and the level of muscle activity around the eyes during everyday facial expressions.
What to Expect During Treatment
The treatment process involves several steps, from your initial consultation to follow-up care after the injections. Knowing what to expect at each stage helps you feel prepared and allows you to plan your schedule around recovery.
Our eye doctors evaluate your under-eye area carefully before recommending this treatment. The best candidates have mild to moderate hollowing with good skin elasticity and no significant forward bulging of fat under the eye. If you have excess loose skin or prominent fat pads, surgical options such as lower blepharoplasty may be a better fit, and our team can discuss that with you.
During the consultation, you will review your goals, go over your medical history, and receive a clear explanation of expected outcomes and potential risks.
Your eye doctor cleans the treatment area and may apply a topical numbing cream before the procedure begins. The filler itself contains lidocaine, a local anesthetic, which provides additional comfort during the injection. Using a fine needle or blunt-tipped cannula, small amounts of gel are placed along the orbital rim, the bony edge surrounding your eye socket, just beneath the skin surface.
The appointment typically takes fifteen to thirty minutes. You remain awake throughout and can return to most normal activities the same day.
Proper aftercare helps you get the best results and reduces your chance of extended swelling or bruising.
- Apply cold compresses for ten minutes at a time during the first 24 hours
- Avoid strenuous exercise, alcohol, and hot environments for 48 hours
- Sleep with your head elevated for the first two nights
- Do not massage the treated area unless your eye doctor specifically instructs you to
- Avoid applying makeup to injection sites for at least 24 hours
Most bruising and swelling can be covered with makeup after the first 24 hours, so most patients feel comfortable returning to work or social activities quickly.
Our eye doctors typically schedule a follow-up visit about two weeks after your treatment. This appointment allows your doctor to assess how the filler has settled and determine whether any minor adjustment is needed. Small asymmetries can often be corrected with a very small amount of additional product at this visit.
Planning maintenance sessions every nine to twelve months helps you sustain the correction over the long term without starting from scratch each time.
Risks and Safety Information
All injectable treatments carry some level of risk, and the under-eye area requires particular care due to its proximity to important structures. Our eye doctors are trained in ocular anatomy and take every precaution to make your treatment as safe as possible.
Bruising, swelling, redness, and tenderness at the injection site are the most frequently reported reactions. These typically resolve within one to two weeks. Because the skin under the eyes is very thin, it tends to bruise more easily than other areas of the face.
Small lumps or slight unevenness can appear as the filler settles into tissue. In most cases, these smooth out on their own within the first two weeks without any additional treatment.
Vascular occlusion, meaning a blockage of a nearby blood vessel, is a rare but serious risk associated with any filler injection in the face. If filler enters a blood vessel, it can reduce blood flow to surrounding tissue and, in the most severe cases, affect vision. This risk is why treatment by a qualified eye doctor with knowledge of periocular anatomy matters.
Our eye doctors keep hyaluronidase available during every filler procedure so that it can be injected immediately if any sign of vascular compromise is suspected.
Because Belotero Balance is made from hyaluronic acid, our eye doctors can dissolve it at any time using hyaluronidase. This enzyme breaks down the gel within hours and can reverse unwanted effects or address complications. This reversibility is a significant safety advantage over permanent or semi-permanent fillers that cannot be removed once placed.
Knowing the treatment can be undone gives both our patients and our eye doctors an important safety option if results are not what was expected or if a concern arises after treatment.
Contact our office right away if you notice any of the following after your treatment.
- Sudden changes in vision of any kind
- Severe or worsening pain that is not typical post-injection soreness
- Skin color changes such as white, gray, or purple patches near the injection site
- Signs of infection including increasing redness, warmth, swelling, or fever
Do not wait to see if symptoms improve on their own. Early treatment of complications can prevent them from becoming more serious, and our team takes urgent concerns seriously.
Frequently Asked Questions
These answers address questions that go beyond the basics covered above, to help you think through whether this treatment is the right fit for your specific situation.
Each filler is formulated for different depths of tissue and different treatment goals. Juvéderm Voluma XC is a thicker HA filler designed to restore volume in deeper structures like the cheek. RADIESSE uses calcium hydroxylapatite and is not reversible, which makes it a less common choice near the eyes. Belotero Balance with CPM technology is specifically suited for the shallow, delicate tissue of the tear trough and is the only one of these products with an FDA indication for that area. Your eye doctor will help you understand which option, or combination of options, makes sense for your goals.
Our eye doctors may ask you to pause aspirin, ibuprofen, fish oil, and vitamin E supplements for about one week before treatment, if it is medically safe for you to do so. These substances thin the blood and increase bruising. You should never stop a prescription blood thinner without first speaking to the doctor who prescribed it, as doing so can carry serious health risks unrelated to your filler appointment.
Yes, and it is important to tell our eye doctors about any existing filler in the area before your appointment. Placing additional product over filler that has not yet been absorbed can create uneven results or increase the risk of lumpiness. Depending on how much filler remains and what type was used, your eye doctor may recommend dissolving it first with hyaluronidase before placing new product for the cleanest outcome.
Hyaluronic acid fillers, including some formulations with CPM technology, are used to treat other areas of the face as well. Treating adjacent areas in the same appointment or at a follow-up visit can create a more balanced, natural-looking overall result. Our eye doctors can evaluate your full facial anatomy during your consultation and discuss whether a broader approach would complement your under-eye correction.
This is an important distinction. Belotero Balance addresses hollowing and the shadow it casts, not pigmentation-based dark circles. If your dark circles are caused primarily by melanin in the skin or visible blood vessels, filler may provide only modest improvement. Our eye doctors will assess the cause of your under-eye concern during your consultation and let you know whether filler is likely to help or whether another approach would serve you better.
You may notice immediate improvement right after treatment, but initial swelling can temporarily make the area appear fuller than the final result. Most patients see their true outcome once swelling settles, typically within one to two weeks. The two-week follow-up visit is timed for exactly this reason, so your eye doctor can evaluate the settled result and make any fine adjustments if needed.
Schedule a Consultation at NewView Eye Center
If under-eye hollowing is affecting how rested or youthful you look, our eye doctors at NewView Eye Center are here to help you explore your options with expertise and care. Our team brings deep knowledge of ocular anatomy and cosmetic injectable techniques to every consultation, so you can feel confident in the hands treating such a delicate area. We welcome patients from across Northern Virginia and look forward to helping you achieve a refreshed, natural result that reflects how you feel.
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