Under-eyes, folds, cheek fullness, jawline, and submental contour
Belluti Lifting Explained
Why every facial area requires a different anatomical assessment
Written by M.D. Bo Won Lee, Director of Springday Clinic Sinchon, Seoul.
The direct answer
Belluti should not be applied to the under-eye area, tear trough, nasolabial fold, deep cheek, jawline, and double chin as though they were one identical problem. Some areas may contain excessive projection or descended tissue, while nearby areas may require volume preservation or structural support.
A diamond-particle patch converts Q-switched laser energy into a mechanical shockwave.
The principal product-specific publication is a single case report involving fat-graft overcorrection.
The central decision is which tissue should be treated and which volume should be preserved.
Why one treatment map does not fit every face
A patient may have a protruding lower-eyelid fat pad immediately above a hollow tear trough. The midface may appear heavy near the nasolabial fold while the submalar region is already deficient in volume. The jawline may look blurred because of fat, skin laxity, the platysma, skeletal support, muscle contour, or gland prominence.
These concerns may be visually connected, but they are not anatomically identical.
How Belluti differs from conventional thermal lifting
Belluti uses a dedicated patch together with a 1,064 nm Q-switched Nd:YAG laser. Published descriptions indicate that black diamond particles within the patch absorb optical energy and convert it into a laser-induced shockwave, or LISW.
This proposed mechanism differs from radiofrequency and focused ultrasound, which primarily rely on controlled heating within tissue. Belluti is therefore better described as a patch-mediated photomechanical treatment rather than a conventional volumetric heating procedure.
The laser is used to activate the patch and generate a mechanical wave. A novel mechanism, however, does not by itself establish predictable efficacy across every facial area.
What product-specific clinical evidence is available?
The principal peer-reviewed Belluti publication identified in the source material is a 2026 case report involving a 38-year-old woman with long-standing malar overcorrection following autologous fat grafting approximately ten years earlier.
The authors reported softening of firm tissue and improvement in excessive volume and facial asymmetry after treatment with the patch and a Q-switched Nd:YAG laser.
Follow-up in the report extended to two months. This is clinically interesting, but the case involved grafted and firm malar tissue rather than untreated native under-eye fat, buccal fat, jowls, or submental fat.
- Predictable reduction of ordinary lower-eyelid fat
- Standardized reduction of native deep-cheek or buccal fat
- Reliable submental-fat reduction in every patient
- Correction of a true tear-trough hollow
- Superiority over HIFU or radiofrequency
- A universal number of sessions
- Long-term durability beyond the reported observation period
Product-specific evidence remains limited. Results may vary, and treatment claims should remain proportionate to the available evidence.
Area 1: Under-eye bags and the tear trough
The lower eyelid and tear trough may appear to be one concern, but they can represent opposite anatomical problems.
A lower-eyelid bag is a projection. A tear trough is a depression along the lid-cheek junction. When projection and hollowing occur together, the transition creates a deeper shadow and may make the face appear tired.
- Orbital-fat projection
- Structural tear-trough hollowing
- Thin or lax skin
- Fine lines
- Pigment or visible vessels
- Recurrent edema
- Loss of midface support
- Mild tissue laxity
- Localized firmness or fullness
- Preference for a non-incisional approach
- Acceptance of gradual rather than dramatic change
- Deep structural hollowing
- Marked orbital-fat prolapse
- Significant skin excess
- Pigment- or vessel-dominant dark circles
- Substantial midface volume deficiency
Treating a hollow as though it were excess volume may accentuate shadowing. This cannot be determined without an in-person assessment.
Periocular laser procedures also require appropriate wavelength-specific eye protection and careful definition of the treatment field.
Area 2: Nasolabial folds
A nasolabial fold is not merely a line in the skin. It may reflect midface descent, reduced malar support, skeletal anatomy, facial animation, dermal creasing, and changes in adjacent fat compartments.
If mild soft-tissue descent contributes to the shadow, improving the surrounding contour may make the fold appear softer. Belluti does not directly fill a structural depression, and a fixed dermal crease may remain.
The midface above the fold often matters more than the visible line itself. Reduction, tightening, structural support, and volume replacement are not interchangeable treatment goals.
Area 3: Deep-cheek fullness
Patients may use the term “deep cheek” to describe buccal fat, deep medial cheek fat, descended superficial fat, jowling, previous fat grafting, injectable material, fibrosis, edema, muscle bulk, or parotid contour.
The published Belluti case involved old fat-graft overcorrection and firm malar tissue. It should not be treated as proof of predictable reduction in normal buccal fat or every form of cheek fullness.
Patients who already have submalar hollowing or limited facial fat require conservative planning. Excessive reduction may reveal skeletal shadows and create a longer or more fatigued appearance.
Area 4: Jawline and jowls
A blurred jawline may result from descended jowl compartments, localized fat, skin laxity, platysmal laxity, limited chin projection, mandibular anatomy, masseter contour, submandibular-gland prominence, or edema.
A retruded or short chin can make the jawline look poorly defined even when subcutaneous fat is limited. Reducing fat alone may therefore produce less improvement than expected.
When skeletal support is adequate but localized soft tissue sits above the mandibular border, a contour-focused treatment may be considered. Treatment mapping should distinguish the jowl from the mandibular border rather than applying an identical pattern across the lower face.
Area 5: Double chin and submental fullness
A palpable fat layer may require comparison with established fat-targeting treatments.
Reducing volume without addressing loose skin may make laxity more apparent.
Muscle laxity or vertical bands can blur the cervicomental angle.
Chin position, mandibular length, hyoid position, and gland contour influence the neck profile.
No independent trial was identified in the supplied article that quantified reduction of ordinary submental fat with Belluti or established long-term durability.
Belluti may be considered as an adjunct for mild localized fullness or laxity, but the degree and duration of fat reduction cannot currently be predicted with confidence.
How Belluti compares with other treatment categories
Patch-mediated laser-induced shockwave. Product-specific clinical evidence remains limited.
Creates focal thermal zones at selected tissue depths. Cartridge depth and anatomical placement matter.
Uses resistive heating for dermal and subcutaneous remodeling. Tissue thickness, cooling, and cumulative energy influence treatment.
Provide volume or support and are not substitutes for reducing excessive fullness.
Injections, cryolipolysis, and liposuction directly target fat through different mechanisms and have distinct recovery profiles.
There is no adequate evidence that one category is universally superior. The correct choice depends on the tissue being treated.
Who may be a reasonable candidate?
□ Mild localized laxity or fullness
□ Preference for a non-incisional treatment
□ Interest in carefully targeted treatment rather than uniform full-face reduction
□ Realistic expectations for gradual change
□ Acceptance that product-specific evidence is limited
□ Ability to return for standardized photography and reassessment
When another treatment may deserve priority
□ Pronounced tear-trough volume deficiency
□ Marked orbital-fat prolapse or significant lower-eyelid skin excess
□ Pre-existing submalar hollowing
□ Moderate or advanced facial and neck laxity
□ Prominent platysmal bands
□ Major chin or mandibular support deficiency
□ Rapid unilateral enlargement or an undiagnosed firm lesion
□ Active inflammation, infection, or an open wound
Possible treatment reactions
The product-specific case report described transient wheals, petechiae, tenderness, edema, and erythema. These reactions improved over several days in that individual case, but the same recovery pattern cannot be guaranteed for every patient.
Bruising, irritation, asymmetry, limited improvement, or an unwanted contour change should also be included in clinical discussion. Reliable incidence rates are not available from large product-specific studies.
Patients should disclose antiplatelet or anticoagulant use, easy bruising, and previous fillers, fat grafting, biostimulators, thread lifting, ultrasound, or radiofrequency procedures.
How many sessions are recommended?
A universal treatment schedule cannot be defined without considering baseline anatomy and tissue response. The manufacturer and clinicians involved in early clinical use commonly recommend approximately three sessions.
Treatment should be reassessed after the initial response and temporary swelling have stabilized.
Session number and interval may depend on tissue type, skin and fat thickness, previous procedures, the distribution of fullness and hollowing, asymmetry, recovery, and the desired degree of change.
What to check when choosing a clinic
The clinician should explain what tissue is causing each visible concern.
The treatment map should distinguish tissue to reduce from volume that should remain.
A single case report should not be presented as a large comparative trial.
Fillers, fat grafting, biostimulators, threads, HIFU, and RF can alter tissue characteristics.
Appropriate eye protection and precise treatment boundaries are essential around the eyes.
The clinic should be able to assess persistent swelling, pain, asymmetry, or unexpected hollowing.
Our assessment approach at Springday Clinic Sinchon
At Springday Clinic Sinchon, treatment areas are not selected solely because a device is available. Assessment may include:
□ The balance between lower-eyelid projection and tear-trough hollowing
□ Malar and midface support
□ The true anatomical location of perceived cheek fullness
□ Jowl and mandibular-border anatomy
□ Submental fat and skin laxity
□ Platysma and submandibular-gland contour
□ Chin and mandibular support
□ Skin thickness and elasticity
□ Previous injectable and energy-based treatments
□ Facial asymmetry and changes during animation
□ Expected benefit, limitations, and follow-up planning
Key takeaways
First, Belluti uses a dedicated patch to convert Q-switched laser energy into a mechanical shockwave.
Second, product-specific evidence is principally based on a single case of fat-graft overcorrection.
Third, the under-eye area, tear trough, nasolabial fold, cheek, jawline, and double chin have different anatomical causes.
Fourth, preserving necessary facial volume is as important as treating excessive fullness.
Frequently asked questions
Conclusion
Belluti is a non-incisional treatment that uses a dedicated patch and Q-switched Nd:YAG laser to generate a mechanical shockwave.
A published case of fat-graft overcorrection reported a favorable response, but that finding cannot be generalized to every under-eye bag, nasolabial fold, deep cheek, jowl, or double chin.
The treatment direction may be opposite in adjacent areas: a tear trough may require preservation or support, while nearby projection may require reduction or tightening.
References
- Lee JB, Byun SJ, Choi YJ, Kim WS. Diamond particle acoustic patch-mediated laser-induced shockwave for refractory facial fat graft overcorrection: a case report. Medical Lasers. 2026;15(1):81-85. DOI: 10.25289/ML.26.001.
- Modena DAO, da Silva CN, Grecco C, et al. Extracorporeal shockwave: mechanisms of action and physiological aspects for cellulite, body shaping, and localized fat—systematic review. Journal of Cosmetic and Laser Therapy. 2017;19(6):314-319. DOI: 10.1080/14764172.2017.1334928.
- Hirmand H. Anatomy and nonsurgical correction of the tear trough deformity. Plastic and Reconstructive Surgery. 2010;125(2):699-708. DOI: 10.1097/PRS.0b013e3181c82f90.
- Jiang J, Wang X, Chen R, et al. Tear trough deformity: different types of anatomy and treatment options. Postępy Dermatologii i Alergologii. 2016;33(4):303-308. DOI: 10.5114/ada.2016.61607.
Begin with an assessment of what should be treated—and what should be preserved.
Springday Clinic Sinchon
