Adding to the ever expanding array of injectable fillers, the recent FDA approval of Belotero Balance by Merz adds another material treatment option for the aesthetic correction of facial wrinkles and folds. Belotero Balance is a monophasic double cross-linked hyauronic-acid gel that has a low viscosity with variable amounts of cross-linking. One of the advantages of this differing cross-linking throughout the product is that it makes the filler elastic, allowing it to flow into the nooks and crannies of the dermis and subcutaneous tissues. This also allows it to be used in very superficial fine lines and wrinkles with a lower risk of lumps and bumps and without creating the classic Tyndall effect. (skin appears pale blue over the filler) Clinical studies have shown it to be equivalent in how long it lasts to the well known fillers, Restylane and Juvederm.
With a large number of injectable fillers to choose from, what are the advantages of Belotero Balance? The void that it appears to fill is that of a fine line or superficial injectable filler. There are a higher incidence of potential problems with many of the other fillers if they are placed superficially in the dermis. What are the disadvantages of Belotero Balance? For deeper lines and folds, the other fillers appear to be a better choice. Their higher viscosities provide a better push when placed deep. Also, it does not come premixed with lidocaine…not that it can’t be independently mixed in immediately prior to injection.
Dr. Barry Eppley
Indianapolis, Indiana