"Wrinkle treatment - what works best where?"
Dermatology & Plastic Surgery 4 I 2011
Today, facial wrinkles can be treated in a variety of ways. While botulinum toxin A is suitable for treating mimic wrinkles, static wrinkles require cross-linked hyaluronic acid or a filler based on calcium hydroxyapatite.
There are numerous options available today for the treatment of facial wrinkles. However, as Dr Michaela Montanari, plastic surgeon in Bochum, emphasises, the large number of products requires regular and critical examination of the constantly growing range. Botulinum toxin A is suitable for the prevention and treatment of mimic wrinkles. It is usually applied to the upper part of the face. However, botulinum toxin can also be used in the lower half of the face, although this requires experience, according to Dr Montanari. Above all, it is important not to impair the patient's natural facial expressions. It is also important to consider the safety profile of the specific product in view of the numerous options available. Another option is natural hyaluronic acid for biorevitalisation and mesotherapy of larger areas of skin.
Dr Montanari: "However, there are signs of skin ageing for which native hyaluronic acid is not sufficient." Cross-linked hyaluronic acid, on the other hand, is suitable for augmenting individual, static wrinkles. Which product is the most suitable in a specific case depends on the depth of the wrinkles. Finally, calcium hydroxyapatite can be used to augment deep wrinkles and even perform a so-called "liquid face lift" and restore facial structures. "There is now a consensus that resorbable fillers should be used. The aim of these procedures is to satisfy the patient, so care should be taken to use the right materials", says Dr Montanari.
The Merz programme covers the entire spectrum of substances available for wrinkle treatment. Bocouture® is pure botulinum toxin A, contains only active neurotoxin, is free of complex proteins and is characterised by rapid onset of action and high stability. Bocouture® is approved for the treatment of glabellar lines and can be stored at room temperature. No cold chain is required, which eliminates the risk of treatment failure or product destruction due to errors in maintaining the cold chain. Due to the low content of foreign proteins, BTX-A from Merz has a low immunogenic potential.
Belotero® is the first filler with innovative CPM® technology (Cohesive Polydensified Matrix) and is available in soft, basic and intense versions. This makes Belotero® suitable for correcting both small superficial and deep wrinkles. Belotero® intense can also be used for volume build-up and contour levelling. Thanks to the CPM® technology, the degradable, multi-cross-linked hyaluronic acid in Belotero® is processed into a cohesive gel with different viscosities that is particularly easy to inject into the skin. Thanks toCPM® , the injected Belotero® gel is particularly stable and ensures a long-lasting cosmetic result.
Radiesse® is a volume filler consisting of a gel matrix (cellulose-based with water and glycerine) and the active ingredient calcium hydroxyapatite. Both components are biocompatible and completely biodegradable. Radiesse ® does not contain any animal products, so an allergy test is not necessary before use. The effectiveness in the form of an effective volume build-up to correct volume and contour deficits is confirmed by comprehensive studies. Radiesse® has been approved by the FDA since 2006.
"Radiesse® has gained an important place in our daily practice in facial volume substitution and is an excellent complement to Belotero products", comments Dr Markus Klöppel from the Department of Plastic Surgery at Martha-Maria Hospital in Munich.
Source: Report: Reno Barth - Symposium of Merz Pharmaceuticals GmbH, "Wrinkle treatment: What works best where?", 30 September 2011, and "Wrinkle correction and volume substitution in the face", 1 October 2011, Frankfurt/Main - 49th Annual Conference of the ÖGPÄRC, Innsbruck - der110400