Belotero Balance (Merz), an injectable hyaluronic acid dermal filler, has been approved by the FDA for temporary correction of moderate-to-severe facial wrinkles and folds. Several other hyaluronic acid products are also available for this indication (e.g., Restylane, Perlane, Juvéderm).1 They have supplanted bovine collagen products, which persist for a shorter time and cause more allergic reactions.

MECHANISM OF ACTION — Cross-linked hyaluronic acid products bind to water, preserving the volume of the injected material until all the hyaluronic acid has been degraded by naturally occurring hyaluronidases. They may also stimulate collagen production.2 In the case of overcorrection or excess fullness, an injection of hyaluronidase can reverse the effects.

CLINICAL STUDIES — Approval of Belotero ... more