18 minute read
BELOTERO Balance & BELOTERO Revive
As a doctor, my background is in medicine, but, ironically, I was probably a much better student of the arts than I was in science at school. The visual arts have always really interested me, and as art is a huge part of aesthetic practice, it made sense for me.
What I enjoy most is rejuvenation. Typically my patients are women who are noticing the signs of ageing or are feeling like they look a little bit tired, and it’s getting them down. Facial rejuvenation, particularly volume replacement using dermal fillers, can make such a profound change to how someone looks and then, ergo, how they feel, which is really what it’s all about. The bulk of my practice is really centred around hyaluronic acid dermal fillers, and I’ve been using the Merz portfolio really since I started about 10 years ago. I know them well, and they are the products we use in our training academy as well. For me, there are genuine advantages of using BELOTERO®, the most important being their low propensity to stimulate an immune response.1 Patient safety is paramount. When it comes to BELOTERO® Revive, I think that Merz Aesthetics has been very clever with it because they’ve tapped into the mindset of the patient and the injector. There are many skin boosters on the market, but one of the frustrating things about them is how long it takes before patients see anything happening! None of these products are going to give anyone a structural change like fuller cheeks or a sharper jawline; it’s all about the skin. The great thing about BELOTERO® Revive is the fact that they’ve introduced glycerol to the product.2 Glycerol is a molecule that will absorb its weight in water in about 72 hours.3 This means patients start to see something happening quickly, usually within three days. It’s a relatively new product. I’ve just started to use it, so I have been ringing all my patients up at three or four days to see what’s happening, and a significant number of them are saying, “It’s hard to put my finger on it, but I just feel like everything just looks a bit plumper.” The glycerol gives you that before the HA starts to kick in. Seeing more instant results keeps patients interested. The other thing I like about BELOTERO® Revive is that you can spot treat. Where someone’s got an issue, particularly with a localised area of skin laxity, that’s just starting to crepe, and it’s not really something that you can fill or volumise. Having something like BELOTERO® Revive up your sleeve to be able to go and spot treat, is particularly useful because it allows you to be a bit more flexible.2 Case Study A 42-year-old female patient presented to me complaining of fine, static lines and textural skin changes, mainly in her lower medial cheek/lateral perioral region. These ‘cat scratch’ lines which are lateral to the cheek and extend to the perioral region,
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with skin texture as they are the lines themselves. She came in asking for filler, but my position was that she wasn’t really a suitable candidate for volumising in the classic sense. I chose to do a spot treatment using BELOTERO® Balance initially for the static lines combined with BELOTERO® Revive to treat the texture2 at subsequent visits. The changes this patient was experiencing were generally related to the ageing process but more specifically to photodamage. She described a combination of fine lines, erythema, hyperpigmentation, and the changes in skin texture, which is really what BELOTERO® Revive is about2 .
Merz Innovation Partner Dr Chris Hutton from Array Aesthetics in Belfast shares his approach to treating a 42-year-old patient with difficult-to- treat lateral cheek lines using a combination of BELOTERO® Revive and BELOTERO® Balance
use a little bit of topical anaesthetic to make it more comfortable. I use a 30-gauge needle and inject as superficially as I can. The 30-gauge needle is what comes as standard with BELOTERO® Revive, and I just inject it generally, covering all the areas that we’re worried about in terms of texture. You can also use a cannula to thread up and down the area. I prefer to use a needle because that’s the method used in the ‘Belove’ study5 .
You want to inject as superficial as you can. It’s difficult to get truly intradermal consistently with a needle, you’re going to realistically be subdermal, but you want to be raising a little bleb in terms of visual feedback2. It’s a straightforward treatment – a very similar technique to superficial blanching, which is a very well-recognised technique. Before
After
are classically tricky to treat as they are as much to do with skin texture as they are the lines themselves. She came in asking for filler, but my position was that she wasn’t really a suitable candidate for volumising in the classic sense. I chose to do a spot treatment using BELOTERO® Balance initially for the static lines combined with BELOTERO® Revive to treat the texture2 at subsequent visits. The changes this patient was experiencing were generally related to the ageing process but more specifically to photodamage. She described a combination of fine lines, erythema, hyperpigmentation, and the changes in skin texture, which is really what BELOTERO® Revive is about.2 We did the first treatment in May 2021. At this visit, I used BELOTERO® Balance to the perioral region, injected with a 30-gauge needle using a superficial blanching technique.4 BELOTERO® Balance is really nice for these sort of static lines, but when you follow it up with BELOTERO® Revive to improve the texture, that puts the icing on the cake. We did the first Revive session two weeks later, concentrating on the lateral perioral region. This was followed by a further Revive treatment four weeks subsequently and a third Revive treatment four weeks after that.2 We used a 1ml syringe to inject 0.5mls of Revive into this area of concern on each side. The treatment is generally well-tolerated, and I tend to use a little bit of topical anaesthetic to make it more comfortable. I use a 30-gauge needle and inject as superficially as I can. The 30-gauge needle is what comes as standard with BELOTERO® Revive, and I just inject it generally, covering all the areas that we’re worried about in terms of texture. You can also use a cannula
I chose to do a spot treatment using BELOTERO® Balance initially for the static lines combined with BELOTERO® Revive to treat the texture2 at subsequent visits. The changes this patient was experiencing were generally related to the ageing process but more specifically to photodamage. She described a to thread up and down the area. I prefer to combination of fine lines, erythema, use a needle because that’s the method hyperpigmentation, and the changes used in the ‘Belove’ study.5 in skin texture, which is really what You want to inject as superficial as you BELOTERO® Revive is about2 . can. It’s difficult to get truly intradermal consistently with a needle, you’re going We did the first treatment in May 2021. At this visit, I used BELOTERO® Balance to the perioral region, to realistically be subdermal, but you want to be raising a little bleb in terms of visual feedback.2 It’s a straightforward treatment – a very similar technique to superficial injected with a 30-gauge needle using blanching, which is a very well-recognised a superficial blanching technique4 . technique. BELOTERO® Balance is really nice for these sort of static lines, but when you In terms of outcome, a gradual improvement follow it up with BELOTERO® Revive to in fine lines, skin texture, feel and improve the texture, that puts the icing hyperpigmentation was noted throughout on the cake. We did the first Revive the treatment course. The patient was session two weeks later, concentrating really pleased overall. What she wanted on the lateral perioral region. This was followed by a further Revive treatment four weeks subsequently and a third Revive treatment four weeks after to achieve, we’ve done, and she’s keen to continue with it. The typical protocol with Revive, subsequent to your first three sessions, is that you get seven to nine months’ of longevity and then typically, you that2. We used a 1ml syringe to inject will need one to two booster sessions a year 0.5mls of Revive into this area of after that.2,5 concern on each side. The treatment is To maintain these results, we’d need to do generally well-tolerated, and I tend to BELOTERO® Balance twice a year and then just top with Revive once or twice a year. That’s what I would be aiming for.
needle is what comes as standard with BELOTERO® Revive, and I just inject it generally, covering all the areas that we’re worried about in terms of texture. You can also use a cannula to thread up and down the area. I prefer to use a needle because that’s the method used in the ‘Belove’ study5 . You want to inject as superficial as you can. It’s difficult to get truly intradermal consistently with a needle, you’re going to realistically be subdermal, but you want to be raising a little bleb in terms of visual feedback2. It’s a straightforward treatment – a very similar technique to superficial blanching, which is a very well-recognised technique. In terms of outcome, a gradual improvement in fine lines, skin texture, feel and hyperpigmentation was noted throughout the treatment course. The patient was really pleased overall. What she wanted to achieve, we’ve done, and she’s keen to continue with it. The typical protocol with Revive, subsequent to your first three sessions, is that you get seven to nine months’ of longevity and then typically, you will need one to two booster sessions a year after that2,5 . To maintain these results, we’d need
in skin texture, which is really what BELOTERO® Revive is about2 . We did the first treatment in May 2021. At this visit, I used BELOTERO® Before Balance to the perioral region, injected with a 30-gauge needle using a superficial blanching technique4 . BELOTERO® Balance is really nice for these sort of static lines, but when you follow it up with BELOTERO® Revive to improve the texture, that puts the icing on the cake. We did the first Revive session two weeks later, concentrating on the lateral perioral region. This was After followed by a further Revive treatment four weeks subsequently and a third to do BELOTERO® Balance twice a year and then just top with Revive Revive treatment four weeks after once or twice a year. That’s what I that2. We used a 1ml syringe to inject would be aiming for. 0.5mls of Revive into this area of Dr Chris Hutton MB BCH BAO (QUB) concern on each side. The treatment is PGCert (AesMed Lon.) completed generally well-tolerated, and I tend to his undergraduate medical training at Queen’s University Belfast. He has undertaken postgraduate education in aesthetic medicine course at the Queen Mary University of London. He is a Merz Innovation Partner and has been published in a European medical journal. AESTHETICS EDUCATION. TAILORED TO YOU, POWERED BY ECADEMY.
needle, you’re going to realistically be subdermal, but you want to be raising a little bleb in terms of visual feedback2. It’s a straightforward treatment – a very similar technique to superficial blanching, which is a very well-recognised technique. In terms of outcome, a gradual improvement in fine lines, skin texture, feel and hyperpigmentation was noted throughout the treatment course. The patient was really pleased overall. What she wanted to achieve, we’ve done, and she’s keen to continue with it. The typical protocol with Revive, subsequent to your first three sessions, is that you get seven to nine months’ of longevity and then typically, you will need one to two booster sessions a year after that2,5 . To maintain these results, we’d need
I chose to do a spot treatment using BELOTERO® Balance initially for the static lines combined with BELOTERO® Revive to treat the texture2 at subsequent visits. The changes this patient was experiencing After were generally related to the ageing process but more specifically to photodamage. She described a combination of fine lines, erythema, to do BELOTERO® Balance twice a hyperpigmentation, and the changes year and then just top with Revive in skin texture, which is really what once or twice a year. That’s what I BELOTERO® Revive is about2 . would be aiming for. We did the first treatment in May 2021. At this visit, I used BELOTERO® Dr Chris Hutton MB BCH BAO (QUB) Balance to the perioral region, injected with a 30-gauge needle using PGCert (AesMed Lon.) completed a superficial blanching technique4 . his undergraduate medical training BELOTERO® Balance is really nice for at Queen’s University Belfast. He has these sort of static lines, but when you undertaken postgraduate education follow it up with BELOTERO® Revive to improve the texture, that puts the icing in aesthetic medicine course at the on the cake. We did the first Revive Queen Mary University of London. He is session two weeks later, concentrating a Merz Innovation Partner and has been on the lateral perioral region. This was followed by a further Revive treatment published in a European medical journal. four weeks subsequently and a third Revive treatment four weeks after that2. We used a 1ml syringe to inject 0.5mls of Revive into this area of concern on each side. The treatment is generally well-tolerated, and I tend to AESTHETICS EDUCATION. TAILORED TO YOU, POWERED BY ECADEMY. For more information on educational content go to www.merz-aesthetics.co.uk/ecademy
needle is what comes as standard with BELOTERO® Revive, and I just inject it generally, covering all the areas that we’re worried about in terms of texture. You can also use a cannula to thread up and down the area. I prefer to use a needle because that’s the method used in the ‘Belove’ study5 . You want to inject as superficial as you can. It’s difficult to get truly intradermal consistently with a needle, you’re going to realistically be subdermal, but you want to be raising a little bleb in terms of visual feedback2. It’s a straightforward treatment – a very similar technique to superficial blanching, which is a very well-recognised technique. In terms of outcome, a gradual improvement in fine lines, skin texture, feel and hyperpigmentation was noted throughout the treatment course. The patient was really pleased overall. What she wanted to achieve, we’ve done, and she’s keen to continue with it. The typical protocol with Revive, subsequent to your first three sessions, is that you get seven to nine months’ of longevity and then typically, you will need one to two booster sessions a year after that2,5 . To maintain these results, we’d need Before
There are genuine advantages of using BELOTERO®, the most with skin texture as they are the lines important being their low propensity themselves. She came in asking for filler, but my position was that she After to stimulate an immune response1wasn’t really a suitable candidate for volumising in the classic sense. I chose to do a spot treatment to do BELOTERO® Balance twice a using BELOTERO® Balance initially year and then just top with Revive for the static lines combined with BELOTERO® Revive to treat the once or twice a year. That’s what I texture2 at subsequent visits. The would be aiming for. changes this patient was experiencing were generally related to the ageing process but more specifically to Dr Chris Hutton MB BCH BAO (QUB) photodamage. She described a PGCert (AesMed Lon.) completed combination of fine lines, erythema, his undergraduate medical training hyperpigmentation, and the changes in skin texture, which is really what at Queen’s University Belfast. He has BELOTERO® Revive is about2 . undertaken postgraduate education We did the first treatment in May 2021. in aesthetic medicine course at the At this visit, I used BELOTERO® Queen Mary University of London. He is Balance to the perioral region, a Merz Innovation Partner and has been injected with a 30-gauge needle using a superficial blanching technique4 . published in a European medical journal. BELOTERO® Balance is really nice for these sort of static lines, but when you follow it up with BELOTERO® Revive to Dr Chris Hutton completed improve the texture, that puts the icing his undergraduate medical on the cake. We did the first Revive training at Queen’s University session two weeks later, concentrating Belfast. He has undertaken on the lateral perioral region. This was postgraduate education in followed by a further Revive treatment four weeks subsequently and a third Revive treatment four weeks after AESTHETICS EDUCATION.aesthetic medicine course at the Queen Mary University of London. He is a Merz Innovation Partner and has been published TAILORED TO . We used a 1ml syringe to inject 0.5mls of Revive into this area of YOU, POWERED BY ECADEMY. in a European medical journal. Qual: MB, BCH, BAO (QUB), PGCert For more information on educational content go to www.merz-aesthetics.co.uk/ecademy (AesMed Lon.)concern on each side. The treatment is generally well-tolerated, and I tend to
use a little bit of topical anaesthetic to make it more comfortable. I use a 30-gauge needle and inject as superficially as I can. The 30-gauge needle is what comes as standard with BELOTERO® Revive, and I just inject it generally, covering all the areas that we’re worried about in terms of texture. You can also use a cannula to thread up and down the area. I prefer to use a needle because that’s the method used in the ‘Belove’ study5 . You want to inject as superficial as you can. It’s difficult to get truly intradermal consistently with a needle, you’re going to realistically be subdermal, but you want to be raising a little bleb in terms of visual feedback2. It’s a straightforward treatment – a very similar technique to superficial blanching, which is a very well-recognised technique. In terms of outcome, a gradual improvement in fine lines, skin texture, feel and hyperpigmentation was noted throughout the treatment course. The patient was really pleased overall. What she wanted to achieve, we’ve done, and she’s keen to continue with it. The typical protocol with Revive, subsequent to your first three sessions, is that you get seven to nine months’ of longevity and then typically, you will need one to two booster sessions a year after that2,5 . To maintain these results, we’d need
@aestheticsgroup @aestheticsjournaluk Aesthetics aestheticsjournal.com Before After to do BELOTERO® Balance twice a year and then just top with Revive once or twice a year. That’s what I would be aiming for. Dr Chris Hutton MB BCH BAO (QUB) PGCert (AesMed Lon.) completed his undergraduate medical training at Queen’s University Belfast. He has undertaken postgraduate education in aesthetic medicine course at the Queen Mary University of London. He is a Merz Innovation Partner and has been published in a European medical journal.
Adverse events should be reported. Reporting forms and information for United Kingdom can be found at www.mhra.gov.uk/yellowcard. Reporting forms and information for Republic of Ireland can be found at https://www.hpra.ie/homepage/about-us/report-an-issue/mdiur. Adverse events should also be reported to Merz Pharma UK Ltd by email to UKdrugsafety@merz.com or on +44 (0) 333 200 4143.
Adverse events should be reported. Reporting forms and information for United Kingdom can be found at www.mhra.gov.uk/yellowcard. Reporting forms and information for Republic of Ireland can be found at https://www.hpra.ie/homepage/about-us/report-an-issue/mdiur. Adverse events should also be reported to Merz Pharma UK Ltd by email to UKdrugsafety@merz.com or on +44 (0) 333 200 4143. Adverse events should be reported. Reporting forms and information for United Kingdom can be found at www.mhra.gov.uk/yellowcard. Reporting forms and information for Republic of Ireland can be
References: 1. Merz Aesthetics, (n.d) Merz Data on File (DOF) BEL-DOF-011_01 REF-0922 2. BELOTERO® Revive IFU 3. Fluhr 2008 - Glycerol and the skin holistic approach to its origin and functionsfound at https://www.hpra.ie/homepage/about-us/report-an-issue/mdiur. Adverse events should also be reported to Merz Pharma UK Ltd by email to UKdrugsafety@merz.com or on +44 (0) 333 200 4143.
References: 1. Merz Aesthetics, (n.d) Merz Data on File (DOF) BEL-DOF-011_01 REF-0922 2. BELOTERO® Revive IFU 3. Fluhr 2008 - Glycerol and the skin holistic approach to its origin and functions 4. BELOTERO® Balance IFU 5. BELOVE1 4. BELOTERO® Balance IFU 5. BELOVE1 References: 1. Merz Aesthetics, (n.d) Merz Data on File (DOF) BEL-DOF-011_01 REF-0922 2. BELOTERO® Revive IFU 3. Fluhr 2008 - Glycerol and the skin holistic approach to its origin and functionsAESTHETICS EDUCATION. 4. BELOTERO® Balance IFU 5. BELOVE1TAILORED TO YOU, POWERED BY ECADEMY.
For more information on educational content go to www.merz-aesthetics.co.uk/ecademy
Adverse events should be reported. Reporting forms and information for United Kingdom can be found at www.mhra.gov.uk/yellowcard. Reporting forms and information for Republic of Ireland can be M-BEL-UKI-1231 Date of Preparation August 2021 found at https://www.hpra.ie/homepage/about-us/report-an-issue/mdiur. Adverse events should also be reported to Merz Pharma UK Ltd by email to UKdrugsafety@merz.com or on +44 (0) 333 200 4143. M-BEL-UKI-1231 Date of Preparation August 2021 M-BEL-UKI-1231 Date of Preparation August 2021
References: 1. Merz Aesthetics, (n.d) Merz Data on File (DOF) BEL-DOF-011_01 REF-0922 2. BELOTERO® Revive IFU 3. Fluhr 2008 - Glycerol and the skin holistic approach to its origin and functions BELOTERO® Balance IFU 5. BELOVE1
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confidence to be
