SEPTEMBER 2020: THE BUSINESS DEVELOPMENT ISSUE

Advertorial Merz Aesthetics

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Using BELOTERO® Volume Dr Kim Booysen shares her experience of using the Merz Aesthetics filler for mid-face restoration As an aesthetic physician, having a scientific understanding of every medical device I use to treat patients has always been of paramount importance to me. BELOTERO® Volume is one of the most trusted and frequently used products in my clinic. Its science is robust, accessible and easy to understand. Its safety profile is excellent,1 it is extremely easy and versatile to use, and with a longevity of up to 18 months2 it is ideally suited to my patient cohort.

Where do I use BELOTERO® Volume the most?

I believe that treating the deep medial cheek fat can significantly improve the signs of facial ageing in the mid-face itself, as well as improve the jowls, jawline and under eye hollows, so this is often a starting point for facial rejuvenation in my patient treatments.3 My favourite product for mid-face volume restoration is BELOTERO® Volume. Using a cannula, I can access the deep medial cheek fat and improve projection, which will help alleviate the appearance of tired eyes and soften nasolabial folds and early jowl formation. Moving more superficially in the layers, I can also restore mid-face contours by smoothing transitions and supporting lax tissues. BELOTERO® Volume can also be used to treat the temples, chin, cheeks and mandibular angle, once I have addressed any structural mid-face loss. BELOTERO® Volume can be used in combination with other BELOTERO® fillers for comprehensive facial rejuvenation.

Why do I think BELOTERO® Volume is so easy to use?

BELOTERO® Volume is a supremely versatile filler, as it can be easily injected at different depths in the facial layers. BELOTERO® Volume is approved for injection in both the subcutaneous and supraperiosteal plane. This allows me to create projection with deeper injections, and then blend and contour by injecting at a more superficial plane, all without changing the type of filler or injectable device. This helps me to minimise bruises, limit injection points and potential infection from compromised sterility. BELOTERO® Volume flows smoothly and is ideal for moulding, so I can inject multiple retrograde threads using a cannula, then I can gently shape the threads into the desired contours.

How is BELOTERO® Volume different from other volumising fillers?

Phase 1 Hyaluronic acid in its original form (single chains, random coil structure).

Phase 2 Linearization of individual hyaluronic acid chains: the random coil structure untangles.

Phase 3 First hyaluronic acid cross-linking process with BDDE: a cellular monophasic gel emerges.

Phase 4 Expansion of the gel that was created in the cross-linking process.

Phase 5 Second cross-linking process, supplemented with additional noncross-linked hyaluronic acid.

High Density Zone • Lasting effect of HA • Filling capacity

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Low Density Zone • Easiest extrusion • Optimal dermal integration

We have all started to move away from the traditional thinking of fillers as being either hard or soft.

Other rheological properties, such as viscoelasticity, that impact tissue integration and projection are becoming more important.

BELOTERO® Volume is known for having high levels of three important rheological properties that can produce an ideal filler: plasticity, elasticity and cohesivity.

Plasticity allows a product to be moulded and shaped, while elasticity allows for recoil after compression and cohesivity ensures the product stays together and doesn’t disperse once Aesthetics | September 2020

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injected. These three qualities are essential for an ideal filler, as they allow a practitioner to sculpt and rejuvenate lost projection, safe in in the knowledge that facial expression won’t distort the new contour and the product won’t migrate over time.

What is the science behind BELOTERO® Volume technology?

Merz Aesthetics utilises Cohesive Polydensified Matrix (CPM) and Dynamic Cross-Linking Technology (DCLT) to create their filler range. This technology is different from other filler technology as it includes a second round of cross-linking, which helps create a 3D structure with areas of high density and low density. These different densities allow the product to integrate into the tissues in a more natural way, with even distribution and less clumping of product than some other filler types. The more homogenous the filler integration, the smoother the integration and the more natural the feel for the patient.4 In ultrasound studies, BELOTERO® Volume has been shown to retain more tissue integration than another leading dermal filler due to its increased cohesivity.2 BELOTERO® Volume has also displayed less pro-inflammatory responses than another leading volumising filler, leading to less risk of inflammatory responses.2 Dr Kim Booysen is an independent aesthetic clinic owner in South East London. She holds degrees in medicine, law, international health management and business management. Dr Booysen’s special interests are medico-legal aesthetics and aesthetic education, while her spare time is spent travelling with her husband and working on local environmental causes.

REFERENCES 1. Prager W, Agsten K, Kravtsov M, Kerscher PM. Mid-Face Volumization With Hyaluronic Acid: Injection Technique and Safety Aspects from a Controlled, Randomized, Double-Blind Clinical Study. J Drugs Dermatol. 2017;16(4):351-357.

2. Micheels P, Besse S, Sarazin D, et al. Ultrasound and Histologic Examination after Subcutaneous Injection of Two Volumizing Hyaluronic Acid Fillers: A Preliminary Study. Plast Reconstr Surg Glob Open. 2017;5(2):e1222. Published 2017 Feb 24. doi:10.1097/ GOX.0000000000001222.

3. Kerscher M, Agsten K, Kravtsov M, Prager W. Effectiveness evaluation of two volumizing hyaluronic acid dermal fillers in a controlled, randomized, double-blind, split-face clinical study.

Clin Cosmet Investig Dermatol. 2017;10:239-247. Published 2017 Jun 29. doi:10.2147/CCID.S135441.

4. Flynn TC, Sarazin D, Bezzola A, Terrani C, Micheels P. Comparative histology of intradermal implantation of mono and biphasic hyaluronic acid fillers. Dermatol Surg. 2011;37(5):637643. doi:10.1111/j.1524-4725.2010.01852.x.

This advertorial was sponsored by Merz Aesthetics.

M-BEL-UKI-0818 Date of Preparation August 2020