Belotero Balance (hyaluronic acid) / Merz Pharma - LARVOL DELTA

Characterizing Major In Vitro Rheologic and Physicochemical Properties of Thermally Altered Hyaluronic Acid Fillers. (PubMed, Dermatol Surg) - "Overall, in vitro heat exposure of tested HA fillers does not alter rheologic and physicochemical properties. These findings suggest that EBDs over preinjected HA fillers are unlikely to compromise filler integrity. Further in vivo validation is necessary."

Journal • Preclinical

BB8 Technique: An Innovative Approach for Delivering Diluted Belotero® Balance to Treat Infraorbital Hollows. (PubMed, Cureus) - "Cohesive polydensified matrix hyaluronic acid (CPM HA, 22.5 mg/mL HA) Belotero Balance gel (CPM-B) is one of the preferred fillers in this region due to its cohesivity and long-held safety reputation...No persistent or serious AEs were reported. The BB8 technique is a safe and straightforward method for IOH rejuvenation, allowing injectors to effectively address this delicate and challenging area."

Journal • Aesthetic Medicine

A smarter dermal filler: Antimicrobial protection and collagen stimulation with niacinamide. (PubMed, Eur J Pharm Biopharm) - "We evaluated the biostimulatory, antimicrobial, anti-inflammatory, and safety profiles of a new niacinamide-enriched cross-linked hyaluronic acid dermal filler (HAR) compared to untreated controls and Belotero Balance® (commercial reference)...HAR inhibited bacterial growth (∼90% Gram-negative; ∼50% Gram-positive), significantly lowered IL-6 and TNF-α levels, and showed excellent biocompatibility with high fibroblast viability and minimal hemolysis. These findings highlight HAR as a multifunctional dermal filler combining essential structural support with regenerative, antibacterial, and anti-inflammatory benefits."

Journal • Aesthetic Medicine • Hematological Disorders • Infectious Disease • Inflammation • IL6 • TNFA

Long-Term Effects of Tear Trough Hyaluronic Acid Filler: A Retrospective Study. (PubMed, J Clin Aesthet Dermatol) - "This study challenges conventional beliefs by demonstrating the extended efficacy of TT-HA fillers, providing evidence of significant improvement in infraorbital hollowing up to 18 months posttreatment. These findings offer valuable insights for clinicians and patients, guiding expectations, and treatment planning in cosmetic dermatology practice. Further research is warranted to elucidate factors contributing to the prolonged longevity of TT-HA fillers to optimize treatment outcomes."

Journal • Retrospective data • Aesthetic Medicine • Dermatology

The Balance of Beauty: Pooled Analysis of Adverse Events With a Cohesive Polydensified Matrix-Hyaluronic Acid Filler in Nasolabial Fold Treatments. (PubMed, Aesthet Surg J Open Forum) - "To evaluate the incidence, severity, and risk factors of AEs following nasolabial fold (NLF) treatment with CPM-B (cohesive polydensified matrix hyaluronic acid filler with 22.5 mg/ml HA; Belotero Balance®; Anteis S.A., Switzerland) across 5 internal clinical studies...When controlling for study, volume was the only significant predictor of AE risk, highlighting the need for physicians to minimize excessive volumes where possible. Future studies should explore AE predictors in more diverse populations and investigate additional risk factors to optimize safety and outcomes."

Adverse events • Journal • Retrospective data • Aesthetic Medicine • Dermatology

The Assessment, Strategy, and Treatment Protocol: Nasolabial Fold Assessment, Strategy, and Treatment With Hyaluronic Acid Fillers in Chinese Patients. (PubMed, Plast Reconstr Surg Glob Open) - "We devised 4 assessment, strategy, and treatment (AST) injection protocols, incorporating NLF etiology and severity, patient expectations, and the selection of Belotero Balance Lidocaine (BBL) and Belotero Volume Lidocaine (BVL) hyaluronic acid fillers...Improvements varied from effacement of superficial nasolabial wrinkles to shallower NLF depth, improvement in cheek projection and nasojugal groove appearance, and smoother submalar contours. The AST protocols provide a strategic reference for combining BBL and BVL in a personalized patient-centric approach for effective, holistic, and balanced NLF corrections and pan-facial aesthetic improvements."

Journal • Aesthetic Medicine

Late Onset Dermal Filler Reactions Preceded by GI Illness: An International Review (AAD 2025) - "Juvederm Volbella, Voluma, and Belotero Balance were most frequently involved... GI illness may incite adverse dermal filler reactions. Providers and patients should monitor symptoms after GI illness and consider early intervention."

Review • Aesthetic Medicine • Dermatology • Gastrointestinal Disorder • Infectious Disease • Novel Coronavirus Disease

Labia Majora Rejuvenation With Hybrid Filler: A Narrative Review of the Literature and Report of Two Cases. (PubMed, J Cosmet Dermatol) - "These two case reports and a narrative literature review suggest that a combined HA/CaHA filler may be a safe and effective treatment for labia majora rejuvenation."

Journal • Review • Aesthetic Medicine • Gynecology

A Prospective, Multicenter, Evaluator-Blind, Randomized, Controlled Study of Belotero Balance (+), a Hyaluronic-Acid Filler with Lidocaine, for Correction of Infraorbital Hollowing in Adults. (PubMed, Aesthet Surg J) - "Belotero Balance (+) is a safe and effective treatment for correcting volume deficit in the IOH."

Journal

Response of 21 Hyaluronic Acid Fillers to Recombinant Human Hyaluronidase. (PubMed, Plast Reconstr Surg Glob Open) - "Restylane Lyft, Restylane-L/Eyelight, and Resilient Hyaluronic Acid (RHA) 1/Redensity were the least resistant. The moderately resistant group comprised of Restylane Silk, Juvéderm Volbella, Revanesse Versa/Lips, and Belotero Balance on the less resistant side to Juvéderm Vollure, RHA 2, Restylane Contour, Juvéderm Ultra, Restylane Refyne, Belotero Intense, Restylane Kysse, RHA 3, Juvéderm Ultra Plus, and Restylane Defyne on the more resistant side...With the increasing popularity of fillers comes the increasing need to dissolve them for both ischemic and nonischemic complications. The majority of hyaluronic acid fillers available on the market are very resistant to hyaluronidase, which must be considered when determining the amount of hyaluronidase to dissolve a particular filler."

Journal

A Multicenter Noninferiority Study Comparing Safety and Effectiveness of Hyaluronic Acid Fillers for Correction of Nasolabial Folds in Chinese Subjects. (PubMed, Plast Reconstr Surg Glob Open) - "In this study, a split-face design was used to compare the effectiveness and safety results of Belotero Balance Lidocaine (BEL) and Restylane (RES, control) to investigate whether BEL is noninferior compared with RES in nasolabial fold (NLF) correction. The study showed that BEL is effective and well tolerated for correction of moderate NLFs in Chinese subjects. Noninferiority of BEL was demonstrated compared with RES, and regardless of applied pain treatment, a further reduction in injection pain was observed in BEL."

Head-to-Head • Journal • Pain

Efficacy and safety of hyaluronic acid filler on the treatment of horizontal neck lines. (PubMed, J Cosmet Dermatol) - "The study demonstrated efficacy in improving the appearance of horizontal neck lines after one session of HA filler injection. The results showed peak improvement at 1 month, but with sustained rejuvenation effects up to 6 months after injection."

Journal • Dermatology

Evaluation of Effectiveness and Safety of Belotero Balance® (+) Lidocaine for Volume Augmentation of the Infraorbital Hollow (clinicaltrials.gov) - P=N/A | N=150 | Completed | Sponsor: Merz North America, Inc. | Active, not recruiting ➔ Completed

Trial completion

Treating Sunken Upper Eyelid With Hyaluronic Acid: Recommendations and Results. (PubMed, J Drugs Dermatol) - "As SUE is one of the most prominent signs of aging, the desire for rejuvenation and the popularity of non-surgical solutions have increased. We present our results with a cohesive HA as a highly suitable filler for SUE. Given the high patient satisfaction, long-lasting results, and reduced complication risk, our presented approach may represent a safe and effective novel treatment strategy.J Drugs Dermatol. 2022;21(9):1002-1008. doi:10.36849/JDD.6745R1."

Journal

How Much Does Filler Apparatus Influence Ease of Injection (and Hence Potential Safety)? (PubMed, Ophthalmic Plast Reconstr Surg) - "The delivery apparatus appeared to be the most influential contributor to filler injection extrusion force, with significant changes in ease of injection correlated to the filler's intrinsic rheological properties, such as viscosity (when standardized to the same syringe for needles tested). Knowledge of such data could influence the injector's ability to maximize patients' safety and clinical results."

Journal

Evaluation of Effectiveness and Safety of Belotero Balance® (+) Lidocaine for Volume Augmentation of the Infraorbital Hollow (clinicaltrials.gov) - P=N/A; N=150; Active, not recruiting; Sponsor: Merz North America, Inc.; Trial completion date: Apr 2022 ➔ Jul 2022

Clinical • Trial completion date

Evaluation of Effectiveness and Safety of Belotero Balance® (+) Lidocaine for Volume Augmentation of the Infraorbital Hollow (clinicaltrials.gov) - P=N/A; N=150; Active, not recruiting; Sponsor: Merz North America, Inc.; Recruiting ➔ Active, not recruiting

Clinical • Enrollment closed

Soft tissue distribution pattern of facial soft tissue fillers with different viscoelastic properties. (PubMed, J Cosmet Dermatol) - "The results of the present study revealed that products that were more fluid and less viscous distributed into more superficial fascial layers than products that were less fluid and more viscous (P < .001). This relationship held true irrespective of injected location."

Journal

Evaluation of Effectiveness and Safety of Belotero Balance® (+) Lidocaine for Volume Augmentation of the Infraorbital Hollow (clinicaltrials.gov) - P=N/A; N=150; Recruiting; Sponsor: Merz North America, Inc.

Clinical • New trial

A Randomized, Blinded, Prospective Clinical Study Comparing Small-Particle Versus Cohesive Polydensified Matrix Hyaluronic Acid Fillers for the Treatment of Perioral Rhytids. (PubMed, Aesthet Surg J) - "While both SP-HAL and CPM-HA are effective at reducing perioral rhytid severity and have similar safety profiles, SP-HAL possesses a longer duration of effect."

Clinical • Journal • Acne Vulgaris

Randomized Double-Blind Controlled Study on the Safety and Efficacy of a Novel Injectable Cross-linked Hyaluronic Gel for the Correction of Moderate-to-Severe Nasolabial Wrinkles. (PubMed, Aesthetic Plast Surg) - "The Ial System Duo achieves long-term permanence (more than 9 months confirmed by ultrasound) in correction of moderate and severe wrinkles, similar to Belotero Basic/Balance. Both products showed a high safety profile and a high degree of subject and physician satisfaction."

Clinical • Journal • Dermatology • Dermatopathology • Fibrosis • Pain

Evaluation of the Merz Cheek Fullness Assessment Scale in the Treatment of Midface Volume Deficit (clinicaltrials.gov) - P=N/A; N=66; Recruiting; Sponsor: Merz Pharmaceuticals, LLC

New trial • Biosimilar

A Pilot Study to Assess the Effectiveness and Safety of Belotero Balance® Injection for Volume Augmentation of the Infraorbital Hollow (clinicaltrials.gov) - P=N/A; N=66; Completed; Sponsor: Merz North America, Inc.; Active, not recruiting ➔ Completed

Clinical • Trial completion

Evaluation of Pain With Belotero® Balance With Integral Lidocaine for Correction of the Nasolabial Folds (clinicaltrials.gov) - P=N/A; N=52; Completed; Sponsor: Merz North America, Inc.; Withheld ➔ Completed

Trial completion

Combination Therapy for Rejuvenation of the Lower Face and Neck (clinicaltrials.gov) - P=N/A; N=20; Not yet recruiting; Sponsor: Nashville Centre for Laser and Facial Surgery

Combination therapy • New trial