BELOTERO BALANCE Treatment Informed Consent - Beauty by Design - beauty-by-design 2026

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The document is an informed consent form for the BELOTERO BALANCE Dermal Filler treatment, outlining the procedure, potential risks and complications, and patient responsibilities. It details various side effects such as bruising, infection, allergic reactions, and the possibility of serious complications like accidental injection into a blood vessel. The patient acknowledges understanding these risks and consents to the treatment voluntarily.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field at the top of the form, ensuring that all personal information is accurate.
In the section regarding treatment areas, specify where you will receive the BELOTERO BALANCE injections. This helps clarify your treatment plan.
Review the list of potential risks and complications associated with the procedure. Acknowledge each point by checking or initialing next to them as required.
Discuss any concerns with your healthcare provider and ensure all questions are answered before proceeding to sign the consent.
Sign and date the form at the bottom, along with a witness signature if necessary, confirming your understanding and agreement to proceed.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much does Belotero filler cost?

Averagely, Belotero Balance costs $650 per syringe to $2,000 per procedure depending on the number of syringes needed for the desired result. US National Average: $650 to 1,000 per syringe.

What is Belotero balance good for?

BELOTERO BALANCE (+) IS A DERMAL FILLER DESIGNED TO FLEX As an HA filler, Belotero Balance (+), composed of hyaluronic acid, being a naturally occurring component of the skin, can be used to restore volume and smooth the lines and wrinkles that form with age.

Is Belotero filler FDA approved?

BELOTERO BALANCE (+) IS NOW FDA-APPROVED.

What are the disadvantages of Belotero?

The main disadvantage or advantage (depending on your goals) of Belotero is that it doesnt last very long. Otherwise, as with other fillers in the market, it can cause temporary swelling and bruising in the area of treatment.

Is Belotero better than Juvederm?

BELOTERO works wonders for fine lines around the mouth, under-eye hollows, and smokers lines. Its precision makes it ideal for subtle enhancements in delicate areas. JUVEDERM is better suited for adding volume to the cheeks, filling deeper wrinkles, and enhancing the lips.

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