Home | Treatments | FAQ

FAQ

Regardless of whether you want to expand your knowledge, learn about solutions to your skin concerns or simply need more information to choose the right treatment – in this section you can find answers to the most common questions regarding our products, services and treatments.

Home | Treatments | FAQ

IMPORTANT NOTICE

Please keep in mind that each country is responsible to make sure the local marketing materials and products related content are up to date with new product information released and updates. For product-related or indication-related content, please refer to the EMEA brand manager team or your local branding team, both teams should have the latest versions of the product information and latest indications. Please make sure to review this page accordingly and update the content based on the updates provided by Brand Management and adjust it based on your local needs.

 

Before your treatment

About Merz Aesthetics® – Questions you could verify with your aesthetic expert

As part of the registration process of drugs and medical devices, all products must undergo rigorous testing to ensure both their safety and effectiveness in preclinical and clinical studies.1-7 For our products we (or Merz Aesthetics®) meticulously documented these findings in numerous studies.8

For instance, RADIESSE® has an impressive track record with over 220 peer-reviewed publications since 2005 and a distribution of 15 million syringes worldwide.8,9 ULTHERAPY® also stands as a testament to its reliability with over 90 peer-reviewed papers, more than 50 clinical studies, and a global presence of over 7800 systems.8,9

BELOTERO® has over 105 publications7,10 is approved for use in 61 markets globally with over 15 million syringes sold worldwide and did show a high patient7,11,12 satisfaction (<93% on average) in various studies.13

  • This additional extensive research and the approval processes underline and support the quality and trustworthiness of the products we offer at Merz Aesthetics®.

Our products by Merz Aesthetics® have a broad international presence and are utilized in various countries across the globe. We have established a strong presence in key regions including North America, Asia Pacific, Europe, Latin America, and the Middle East. Our commitment to providing effective aesthetic solutions has enabled us to serve healthcare professionals and clients in diverse geographical locations, ensuring that people worldwide can benefit from our trusted treatments and products. Whether you’re in North America, Asia Pacific, Europe, Latin America, or the Middle East, you can find our products available through reputable healthcare providers who prioritize quality and excellence in aesthetic medicine.

Since 2005, Merz Aesthetics® has sold 15 million syringes of RADIESSE®, 15 million syringes of BELOTERO® and over 2 million ULTHERAPY® treatments have been administered.8

Merz Aesthetics® carries out regular surveys on patient satisfaction. The results are convincing: 98% patient satisfaction* with RADIESSE®.14 95% patient satisfaction reported after 1 year following ULTHERAPY® treatment.14,15 In a direct comparison with other hyaluronic acid fillers, BELOTERO® did show a patient satisfaction of more than 93 %.7,12

*4 months after second treatment

Wrinkles, volume loss & contouring

The most important information about wrinkles, volume loss and contouring treatments.

Wrinkles that appear on our face can be classified into three categories: dynamic (also called expression lines), static and actinic.

Dynamic wrinkles on our face are caused through movement of our facial muscles. If the muscles are active, for instance when laughing, the skin on top of the muscles moves too. This initially causes fine lines to form, which later develop into wrinkles and creases. A classic example of dynamic wrinkles are the so-called crow’s feet lines at the corners of the eyes. Other dynamic wrinkles are forehead lines and the “folds” between the eyebrows.

Static wrinkles form on areas of the skin where the subcutaneous muscles slacken, or gravity pulls the skin downwards due to decreasing tissue strength and volume loss. The skin and connective tissue then sag and form these particularly visible wrinkles. The most common types of static wrinkles are the so-called marionette wrinkles, which run from the corners of the mouth down towards the chin. Or the nasolabial folds between the corners of the mouth and the nostrils.

Actinic wrinkles are caused by external influences, especially excessive sun exposure. They predominantly appear on the face, hands and arms as well as the neck and décolleté (chest area).

Muscle Relaxant

Most muscle relaxation treatments are type A proteins produced by the bacterium Clostridium botulinum and has been known since the 19th century.16  It has been used successfully in medicine for decades, for example to treat certain movement disorders, spasticity, for example after a stroke, torticollis or eyelid spasms.17  Since the mid-1990s, it has also been used to smooth out wrinkles caused by facial expressions and to treat hyperhidrosis (excessive sweating). The bacterial metabolite of muscle relaxants inhibits the release of acetylcholine, a messenger substance that inhibits the conduction of excitation from the nerves to the muscle and thus relaxes the muscles18 , such as the glabellar lines (frown lines), horizontal lines on the forehead or mimic lines around the eyes.19

Wrinkles or lines that appear on the forehead, between the eyebrows or around the eyes (crow’s feet). These wrinkles are dynamic, and their usual treatment is with muscle relaxants.

There is no expected downtime, depending on the injected muscle and the type of wrinkle, the effect is usually seen within a couple of days.

Taking into account all relevant factors such as age, skin type, individual goals, etc., the aesthetic expert makes the diagnosis and finds the appropriate treatment according to your desired results. Afterwards, the muscle relaxant is injected using a very fine needle, usually the treatment itself takes around 20 minutes.

Dermal Fillers

Dermal fillers are substances that are injected below the skin. They are used to correct wrinkles, replenish loss of structure and support.

Dermal fillers are generally absorbable substances that are naturally degraded by the body over time.

Based on your individual needs your aesthetic expert will advise if, for example BELOTERO®, a hyaluronic acid filler, would be suitable for you.

BELOTERO® from Merz Aesthetics® have earned the trust of millions, consistently meeting the highest quality standards.

Our premium BELOTERO® Collection is thoughtfully designed to align with your unique desires while preserving your natural features and expressions. Whether you seek to enhance your skin’s radiance, address lines and wrinkles, rejuvenate and firm your skin, or perfect the appearance of your lips, the BELOTERO® Collection is your path to achieving results that harmonize seamlessly with your natural beauty. It’s a choice that is long lasting* and has been proven through extensive research.13,20-29

*Duration ranges from 4 months and is seen up to 18 months in many patients.

Depending on the size of the area to be treated, one session with prior consultation can last from 15 to 45 minutes.

The aesthetic effect will be noticeable immediately after the treatment. Over time the results will develop further.

With high-quality dermal fillers, worries that the treatment will make you look unnatural or change your authenticity are unfounded. Your aesthetic expert can achieve beautiful natural-looking results by creating smooth and even transitions between treated and non-treated areas. In general, your expressions will not be affected, and you will still be yourself.

The results of your treatment will depend on your age, skin type, lifestyle, metabolism, and the area treated.

With BELOTERO®, the hyaluronic acid filler collection, results can last for between six and twelve months depending on the product used.28-30

Immediately after the treatment, you might be able to feel the product when you touch the area. However, it is important to avoid pressing or massaging the treated area. After a short time, the filler will completely integrate with the tissues, and this will feel more natural.

All products by Merz Aesthetics® have been scientifically tested for safety and efficacy. The BELOTERO® collection has a well-established safety profile, shown in both, short-term, and long-term clinical assessments.7,10,11 Your aesthetic expert will be able to provide you with more detailed information on this and address any of your concerns for the possibility of side effects.

Each patient’s pain threshold is different, but your aesthetic expert will do its best to minimize discomfort during treatment.

Dermal filler injections are generally well-tolerated. For sensitive areas and patients with low pain thresholds, some fillers are also available with lidocaine. In addition, a local painkilling agent can ensure even more comfort during the treatment.

Ask your aesthetic expert about it.

Some side effects may occur directly after treatment such as areas of redness or swelling, short-term sensitivity to touch, areas of hardness and a palpable infiltrate at the injection site. Other possible side effects are usually injection related. Ask your aesthetic expert for more information.

Treatment costs depend on the scope of the treatment and the treating physician. For example, wrinkle correction or facial enhancement will probably cost less than your annual investment in skincare and anti-aging cosmetic treatments. In return, you can enjoy immediate effects that last for a good amount of time. For more information, ask your aesthetic expert for an initial consultation.

Biostimulators

As we age, our skin loses its once firm support and structure. Biostimulators are a category of injectable treatments which help regenerate and restore

the natural components of your skin foundation to improve the structure and support for more youthful-looking, firmer skin.31,32 Biostimulation is the triggering of the body’s natural biological processes, after a stimulus has been given, to go beyond collagen stimulation and promote long-term skin health.33,34

When we speak about skin aging, we are actually talking about the process of losing the key components of the skin foundation which when we are young, keep our skin firm, tight and shapely. These key components consist of collagen, elastin, and blood vessels amongst others, and over time, the natural impulse to produce these key components diminishes. As  a result, you begin to see the common signs of aging like formation of wrinkles, lines and skin sagging set in.35,36 Biostimulators act to directly stimulate the body’s natural creation of collagen, elastin, and key components which provide support and structure to the skin and help smooth out wrinkles.37,38 By increasing the production of collagen, elastin and key components of the skin foundation, we can meaningfully re-build the skin at the source where aging occurs.36,39  This provides long-term skin regeneration for up to 12 months or .40-42  Biostimulators are an important investment in your skin that boost collagen and help to reverse signs of aging.38

Our biostimulatory product is composed of Calcium Hydroxylapatite (CaHA), which is a biodegradable treatment that stimulates the production of collagen, elastin and key components of the skin which are essential for promoting healthy-looking skin*.37,43 Biostimulators get to work directly on the fibroblasts which are “the factories” in our bodies these key components of the skin. These factories switch off with age and produce less, which over time leaves your skin sagging, less contoured and less regenerated.35,36 Therefore biostimulators are used for triggering the body’s natural process for production of the skin’s key components to provide lift and structure to aging tissues, but also improving the skin vitality.34,37,41,43

*Healthy-looking skin” is defined by regeneration of collagen I and III, elastin, proteoglycans, and angiogenesis

Dermal Fillers with hyaluronic acid (HA) and glycerol help to limit wrinkle formation, hydrate the skin and redefine skin structure, for a younger, more radiant look.44,45

Merz Aesthetics® offers RADIESSE® which is the only evidence-based regenerative biostimulator with a uniquely designed formulation and technology offering you an individualized treatment approach –tailored to your unique needs.41,42,46,47

  • Improves skin foundation37,43
  • Meaningfully rebuilds skin48
  • Renews healthy skin tissue41,49

The procedure is minimally invasive treatment and injected under the skin, with high patient satisfaction,8,50,51 as shown in a number of studies. It requires little to no downtime. You can usually resume your normal activities immediately after the procedure.
The result can leave your skin regenerated41 with an improvement in skin quality, but also contour and structure depending on the treatment performed which deliver on an immediate and long-lasting, natural-looking result.32,41,43,52

The duration of the effect depends on age, skin type, lifestyle, metabolism, and, of course, the area treated. Results are normally particularly durable, lasting up to 12 months. In some people, results have lasted even longer, up to 18 months to 2 years.53,54

Microfocused Ultrasound with real-time visualization

ULTHERAPY® is a truly non-invasive treatment and is able to target the same skin layers as a modern face-lift.

Only ULTHERAPY® uses integrated real-time visualization, which allows practitioners to actually see the layers of tissue targeted during the treatment to ensure the energy is delivered precisely to where it will be most beneficial for you.

This procedure involves no surgical incisions or other invasive measures. Instead, it operates by generating controlled heat deep within the dermal and subcutaneous layers. This brief increase in temperature, placed at the precise depth required, essentially jump-starts the body’s own process to create fresh, new collagen.15

The treatment takes about 30 to 90 minutes, depending on the area treated, and there is no downtime afterward as ULTHERAPY® does not disrupt the surface of the skin.55

ULTHERAPY® has a well-established safety profile based on clinical data shown in various studies.2,15,56

The treatment is scientifically proven with over 50 clinical studies, is currently marketed worldwide in more than 80 countries, and over 2 million treatments have been performed globally.2,8,15,56-61 In addition, the medical application of ultrasound energy has a proven track record of more than 50 years.

As the ultrasound energy is delivered, you may feel tiny amounts of energy being deposited to precise depths, stimulating the collagen-building process. Comfort levels vary from person to person, but the sensation only lasts while the ultrasound energy is being delivered.55

Since the procedure stimulates a person’s own collagen production, the duration of the results depends on the individual. You may see some initial lift but, the ultimate results will develop over three to six months, as the growth of new collagen restructures the tissue targeted by the treatment.7,15 A single ULTHERAPY® treatment can give a lasting effect for a year or more15,56 and your physician will advise on the likely outcomes for you.

Rejuvenation & revitalization

The most important information about skin rejuvenation and revitalization with a beauty booster.

As we age, several factors contribute to the appearance of aging skin. From approximately the age of 25, our skin gradually loses its ability to retain moisture, a crucial element for maintaining a youthful and vibrant complexion. This loss of moisture can lead to a sallow, tired, and dull appearance. Additionally, the skin’s suppleness and elasticity decline, and the first signs of fine lines may begin to emerge.

One significant contributor to aging skin is the decrease in collagen production. During early adulthood, the body produces collagen at a robust rate. However, as we age, the rate of collagen production diminishes, making it challenging for the skin to repair and replace lost collagen—a natural part of the aging process.62 Over time, collagen fibers may become fragmented, further affecting the skin’s structure and elasticity.35

This decline in moisture retention and collagen production are key factors in the aging process, leading to the visible signs of aging of the skin.

Find out more about skin aging

The primary reason for inadequate moisture retention in the skin lies in the insufficient presence of crucial moisturizing substances such as hyaluronic acid and glycerin. These substances play an important role in maintaining a constant supply of moisture to the skin cells from deep within, resulting in a taut and fresh appearance on the outside. When these essential substances are lacking, the early signs of aging can manifest sooner, affecting the skin’s overall vitality and youthful look.

Find out more about beautiful skin – To be reviewed

Ever since scientists ascertained the importance of hyaluronic acid for the skin and that it could be produced artificially, it has been included in countless cosmetic products. Applied externally to the skin, however, its effect is limited. The skin’s natural protective layer mostly prevents the hyaluronic acid from penetrating deep enough into the skin to work from the inside. Therefore, skincare products can only superficially supply the skin with this moisture-retaining substance.

Discover more about anti-wrinkle creams – To be reviewed

You can enhance your skin’s appearance without altering your natural features using three innovative treatments: BELOTERO® Revive, RADIESSE®, or ULTHERAPY®:

With a beauty booster like BELOTERO® Revive, an aesthetic expert will inject the moisturizing glycerin and water-binding hyaluronic acid into the skin – right where they are needed. The skin’s moisture supply is optimized, thus leading to improved radiance, elasticity and skin quality.63 However, the contours of the face remain unchanged.

The microfocused ultrasound ULTHERAPY®, targets the right layers to stimulate your collagen production and creates a lifting and tightening effect without disturbing the surface of the skin.2

RADIESSE® is a unique treatment that actively regenerates41,64 and restores the essential components of your skin, providing structural support for a more youthful and firmer appearance.65 It promotes the production of collagen and key skin components, in order to deliver immediate lift, contour, and definition while also offering long-lasting improvements in skin quality.9,43

To enjoy the full effect of BELOTERO® Revive, the treatment should initially be repeated two or three times at four-week intervals in order to fully replenish the skin’s moisture reservoirs. However, the skin’s moisture supply already improves after the first treatment. BELOTERO® Revive has shown a duration of effect of up to 9 months.63 This ensures particularly long-lasting revitalization. After seven to eight months, the effect can be refreshed with a one-off treatment.

RADIESSE® results are normally particularly durable, lasting at least 12-18 months. The duration of the results depends on age, skin type, lifestyle, metabolism, and, of course, the area treated.

In some people, results have lasted even longer – 18 months to 2 years.2,35

Since ULTHERAPY®, stimulates a person’s own collagen production, the duration of results depends on the individual. You may see some initial lift but, the ultimate results will develop over three to six months, and can last for 1 year and longer, as the growth of new collagen restructures the tissue targeted by the treatment.7,15

Lips

The most important information about lip enhancement with hyaluronic acid fillers for natural-looking volume and beautiful contours.

There is no straightforward answer to this question – after all, beauty depends on many factors: there is no one perfect lip shape, but rather many different yet equally beautiful variations. In general, however, the combination of natural volume, sensuous contours, symmetry, and an appropriate size ratio between the top and bottom lips are considered appealing. A distinctive Cupid’s bow (the double curve at the middle of the upper lip) also tends to give the lips a more attractive appearance.

Find out more about lip types- To be reviewed

Do you want to change your lip shape or correct the contours of your lips? Your aesthetic expert can use a hyaluronic filler to change the appearance of your lips according to your wishes. During a pre-treatment consultation, they will always recommend lip correction with results that look as natural as possible. In your actual treatment, hyaluronic acid will be gently injected into the lips to create, for example a symmetrical look and to further define the Cupid’s bow. Wrinkles around the lips (lipstick lines or smoker’s lines) can also be corrected using a hyaluronic acid filler.

Find out more about lip aging – To be reviewed

Lip treatment with hyaluronic acid (without prior consultation) takes around 30 minutes.

The cost of a treatment with lip filler injection is relatively manageable but varies depending on the specific treatment objectives. For more information, ask your aesthetic expert in an initial consultation.

The lip area is very sensitive. However, the treatment is particularly gentle, and most lip fillers already contain a local anesthetic. Your aesthetic expert can also use a numbing cream if required.

  1. Coleman WP 3rd, et al. Dermatol Surg. 2017 Dec;43 Suppl3:S293-S303.
  2. Fabi SG, et al. J Drugs Dermatol. 2019;18(5):426-432.
  3. Fagien S, et al. Plast Reconstr Surg. 2019 Apr;143(4):707e-720e.
  4. Goldie K. J Cosmet Dermatol. 2023; Mar;22 Suppl 1:1-7.
  5. Kadouch JA. J Cosmet Dermatol. 2017;16(2):152-161.
  6. Kerscher M et al. Dermatol Surg. 2015;41:1149-1157.
  7. Vandeputte J. J Clin Aesthet Dermatol. 2018 Dec;11(12):30-39.
  8. Merz Aesthetics®. Data on file.
  9. FDA approval as a medical product; BELOTERO® P090016 (approval refers to BELOTERO® Balance, in Europe BELOTERO® Basic), RADIESSE® P050037, P050037, P050052. ULTHERA® System FDA product classification 878.4590.
  10. Prasetyo AD et al. Clin Cosmet Investig Dermatol. 2016;9:257–280.
  11. Fischer TC, et al. Facial Plast Surg. 2016 Jun;32(3):283-8. Data on File.
  12. Kammerer S. Dermatol News. 2007;11:2-3.
  13. Tran C, et al. Dermatology. 2014;228(1):47-54.
  14. Moers-Carpi, M. et al. Dermatol Surg 2007;33(Suppl 2):S144–151.
  15. Werschler WP, Werschler PS. J Clin Aesthet Dermatol. 2016;9(2):27-33.
  16. Dhaked RK, et al. Indian J Med Res. 2010;132(5):489–503.
  17. BOTOX® (onabotulinumtoxinA) celebrates 30 years of endless innovation [Internet]. 2019. Available from: https://news.abbvie.com/news/allergan-press-releases/botox-onabotulinumtoxina-celebrates-30-years-endless-innovation.htm. Accessed date: May 2023.
  18. Frevert, Jürgen.  Drugs R&D (2015).
  19. Merz Pharmaceuticals GmbH. Press release: Merz announces European approval of BOCOUTURE® for the treatment of upper facial lines. 2016.
  20. BELOTERO® Instructions for Use. Merz Aesthetics®.
  21. BELOTERO® Instructions for Use. Merz Aesthetics®.
  22. BELOTERO® Lips Contour. Instructions for Use. Merz Aesthetics®.
  23. BELOTERO® Lips Shape. Instructions for Use. Merz Aesthetics®.
  24. BELOTERO® Instructions for Use. Version 3.0. Merz Aesthetics®.
  25. BELOTERO® Instructions for Use. Merz Aesthetics®.
  26. BELOTERO® Instructions for Use. Merz Aesthetics®.
  27. Brandt FS, Cazzaniga A. Clin Interv Aging 2008;3:153–159.
  28. Micheels P, et al. Dermatol Surg 2012;38:1162–9.
  29. Micheels P, et al. J Clin Aesthet Dermatol 2015;8:28–34.
  30. Kerscher M et al. Clin Cosm Inv Dermatol. 2017;10:239-247.
  31. Nowag, B, et al. J Cosmet Dermatol. 2023;22(2):426 432.
  32. Yutskovskaya Y, et al. J Drugs Dermatol 2014;13:1047–52.
  33. Draoui, O. The story of calcium hydroxylapatite. In: van Loghem J, ed. Calcium Hydroxylapatite Soft Tissue Fillers.
  34. Van Loghem, J, et al. J Clin Aesthet Dermatol. 2015;8(1):38-49.
  35. Fisher, GJ, et al. Arch Dermatol. 2008;144(5):666–672.
  36. Varani, J, et al. Am J Pathol. 2006;168(6):1861–1868.
  37. González, N, Goldberg, DJ. Dermatol Surg. 2019;45(4):547–551.
  38. Wollina, U, Goldman, A. Dermatol Ther. 2020;33(6):e14183.
  39. Courderot-Masuyer, C, et al. J Cosmet Dermatol. 2016;15(3):260–268.
  40. Fabi, SG, et al. J Drugs Dermatol. 2021;20(5):534–537.
  41. Kim, J. Clin Cosmet Investig Dermatol. 2019;12:771–784.
  42. RADIESSE® Instructions for use. 2023.
  43. Yutskovskaya, YA, Kogan, EA. J Drugs Dermatol. 2017;16(1):68–74.
  44. Bukhari et al., Int J Biol Macromolecules, 2018; 120:1682-1695.
  45. Glycerol and hydration: Korponyai C et al., Acta Derm Venerol, 2017; 97:182-187.
  46. Bagnenko, E, Povzun, S. Injection Methods in Cosmetology. 2018;(2):46–50.
  47. RADIESSE® (+). Instructions for use. 2023.
  48. Varani, J, et al. J Invest Dermatol. 2004;(122):1471–1479.
  49. Nowag, B. Presented at Aesthetic and Anti-Aging Medicine World Congress;2019.
  50. Moers-Carpi, MM, Sherwood, S. Dermatol Surg. 2013;(39):457–463.
  51. Muti, GF. J Drugs Dermatol. 2019;(18):86–91.
  52. Marmur, ES, et al. J Cosmet Laser Ther. 2004;(6):223–226.
  53. Bass, LS, et al. Aesthet Surg J. 2010;(30):235–238.
  54. Van Loghem, J, et al. J Clin Aesthet Dermatol. 2015;(8):38–49.
  55. Merz Aesthetics®. ULTHERAPY®. Instructions for Use.
  56. Fabi SG, et al. J Am Acad Dermatol 2013;69:965–71.
  57. Park JY, et al.. J Clin Aesthet Dermatol. 2021_May;14(5):E70-E79.
  58. Pavicic T, et al. Cosmet Dermatol. 2022 Feb;21(2):636-647.
  59. Baumann L., Zelickson B. J Drugs Dermatol. 2016;15(5):607-614.
  60. Sevi, J. See. Plan. Treat.: Protocol Brief & Practice Case Study.
  61. FDA-clearance for décolleté indication: https://www.accessdata.fda.gov/cdrh_docs/pdf13/K134032.pdf.
  62. Uitto J. J Drugs Dermatol 2008;7:s12–6.
  63. Hertz-Kleptow D, et al. Clin Cosmet Investig Dermatol. 2019;12:563-572.
  64. Nowag B, et al. J Cosmet Dermatol. 2023 Aug 18. doi: 10.1111/jocd.15928. Epub ahead of print. PMID.
  65. Goldie K, et al. Dermatol Surg. 2018 Nov;44 Suppl 1:S32-S41. doi: 10.1097/DSS.0000000000001685. Erratum in: Dermatol Surg. 2019 Feb;45(2):327. PMID: 30358631.