Merz (United States)

ABSTRACTBackgroundGlucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) have gained rapid popularity for both medical and consumer‐directed weight loss. This growth has been accompanied by increased public discussion regarding facial aesthetic changes, commonly referred to as “Ozempic face,” characterized by volume depletion and cutaneous laxity.ObjectiveTo quantify temporal patterns of public search interest in a widely known GLP‐1 RA and evaluate corresponding awareness of its cosmetic facial sequelae using infodemiologic methods.MethodsGoogle Trends data for “Ozempic” and related frequently co‐searched queries were analyzed from November 2021 to December 2024. Trends in relative search volume (RSV) were examined, with particular focus on terms associated with facial aesthetics, including “Ozempic face” and “plastic surgeons Ozempic face.”ResultsRSV for “Ozempic” showed a steady upward trajectory over the study period. Queries related to facial aesthetic consequences exhibited substantial proportional increases. Notably, “Ozempic face” demonstrated a 4600% rise in RSV, and searches for “plastic surgeons Ozempic face” similarly grew markedly.ConclusionsPublic interest in GLP‐1 RAs is strongly associated with rising awareness and concern about their facial aesthetic effects. These trends suggest that aesthetic practitioners should expect more patient inquiries regarding GLP‐1–related facial changes and should proactively integrate counseling and corrective treatment options into clinical practice.

ABSTRACTBackgroundCombining calcium hydroxylapatite‐carboxymethylcellulose (CaHA‐CMC) with hyaluronic acid (HA) products using Cohesive Polydensified Matrix (CPM) technology leverages the volumizing and hydrating effects of HA and draws upon the regenerative properties of CaHA‐CMC, providing a potentially synergistic approach in aesthetic filling treatments. Despite this potential, the rheological and physical properties of these hybrid fillers remain unreported.ObjectiveTo characterize the rheological properties of CaHA‐CMC blended with various CPM‐HA products and identify factors influencing their physical and clinical behavior.MethodsHybrid fillers were prepared by mixing CaHA‐CMC with different CPM‐HA products at varying ratios (1:1 to 1:4 syringe CaHA:syringe CPM). Rheological properties, including storage modulus (G′), loss modulus (G″), complex shear modulus (G*), tan delta (tan δ), and complex viscosity (η*), were measured using an oscillatory rheometer. Extrusion force, cohesivity, stability, and axial strain (εa) were also evaluated.ResultsThe rheological properties of the hybrid fillers varied with the type of HA, mixing ratio, and crosslinking degree. Higher HA concentrations increased G′, G″, and η*, enhancing gel stiffness and resistance to deformation, while increased HA dilution and lower crosslinking favored spread and injectability. The addition of CaHA‐CMC to CPM‐HA products always increased the G′ in a volume‐dependent manner. These properties were closely correlated with the fillers' performance in different tissue planes.ConclusionsThe properties of CaHA‐CMC and CPM‐HA hybrids influence their injection behavior and clinical outcomes. Understanding these factors can guide filler selection and application techniques to maximize safety, efficacy, and patient satisfaction in aesthetic treatments.

Skin quality is a multidimensional concept encompassing four emergent perceptual categories (EPCs): firmness, surface evenness, tone evenness, and glow. Microfocused Ultrasound with Visualization (MFU-V; Ulthera System) is a non-invasive device FDA-cleared for lifting and tightening of the skin in specific areas. Through the generation of thermal coagulation points at defined depths, MFU-V initiates neocollagenesis and elastin remodeling, which may support improvements in features related to overall skin quality. To evaluate clinical and preclinical evidence for the impact of MFU-V across the four EPCs of skin quality, including firmness, surface evenness, tone evenness, and glow. A structured narrative review was conducted across PubMed, Google Scholar, and Cochrane databases. Of 703 unique records screened, 67 studies met inclusion criteria. Eligible studies evaluated MFU-V, alone or in combination, reporting outcomes mapped to one or more EPCs of skin quality. MFU-V demonstrated consistent improvements in firmness (n = 52 studies), including elasticity and tautness, with sustained effects beyond 6 months. Improvements in surface evenness (n = 35) included wrinkle reduction, pore refinement, and scar remodeling. Effects on tone evenness (n = 4) were observed in melasma and erythema models, with good tolerance in Fitzpatrick skin types III-VI. Glow (n = 4) was indirectly supported by improved texture and structure. Combination protocols involving MFU-V and fillers or neuromodulators reported positive outcomes. Adverse events were rare and transient. MFU-V provides a safe and versatile platform for enhancing multiple aspects of skin quality. Its effects are well supported in firmness and texture, with emerging evidence for tone and glow. The integration of EPC-based outcomes may inform individualized treatment planning and future research.

One of the early signs of aging is loss of jawline contour. Not all cases require surgical intervention and soft-tissue augmentation with injectable fillers may restore the profile and youthful appearance of the jawline. To demonstrate the effectiveness and safety of calcium hydroxylapatite with lidocaine [CaHA (+); Radiesse® (+)] to improve the contour of jawline after deep (subdermal and/or supraperiosteal) injection. Healthy eligible patients with moderate or severe ratings on the Merz Jawline Assessment Scale (MJAS) were randomized 2:1 to treatment with CaHA (+) or to control. Patients in the control group remained untreated until week 12, then received delayed treatment. Touch-ups were allowed in both groups, and re-treatment was allowed in the treatment group only. Effectiveness was evaluated on the MJAS, patient and investigator Global Aesthetic Improvement Scales, and FACE-Q™ questionnaires. Adverse events were recorded over a 60-week period. Treatment response rate (≥1-point MJAS improvement) was 93/123 (75.6%) for the treatment group and 5/57 (8.8%) for the control/delayed-treatment group at week 12. The difference between response rates was statistically significant (P<0.0001), showing superiority of treatment over control. Satisfaction with aesthetic improvement was reported by patients and treating investigators throughout the study. A total of 76/113 (67.3%) patients who responded to treatment 12 weeks after initial injection also demonstrated persistent improvement 48 weeks after initial treatment. The study demonstrated a favorable safety profile, with no reported unexpected adverse events. CaHA (+) is a safe and effective treatment for improving the contour of the jawline. J Drugs Dermatol. 2021;20(11): 1231-1238. doi:10.36849/JDD.6442.

Facial aging is characterized by volume loss and progressive hollowing of temples and cheeks. Biodegradable filler materials are preferred over nonabsorbable materials; of these, hyaluronic acid (HA) fillers are the most often used because of their favorable effectiveness and safety profile. To confirm the safety and effectiveness of Cohesive Polydensified Matrix (CPM)-HA26 gel in the treatment of volume deficiency. Subjects received up to 2 treatments in the temples and/or cheeks. A blinded investigator assessed improvement according to the Merz Temple Volume Scale (MTVS) and Merz Cheek Fullness Assessment Scale (MCFAS). Subjects were followed for 48 weeks after the last treatment. In total, 87 healthy subjects were enrolled. The proportion of subjects achieving at least a 1-grade improvement on MTVS and/or MCFAS was above 70% for each (MTVS: Weeks 4, 24, and 48 = 95.4%, 94.2%, and 77.0%; MCFAS: Weeks 4, 24, and 48 = 92.3%, 83.1%, and 71.8%). Based on MTVS and MCFAS scores at Visit 5, improvement remained visible at up to 48 weeks. No treatment-related serious AEs occurred. CPM-HA26 demonstrated both a favorable safety and effectiveness profile, with improvement in facial volume evident for up to 48 weeks. It was well tolerated and had a positive, long-lasting effect.

PurposeThis study sought to perform a real-world, long-term cost-minimization analysis for incobotulinumtoxinA (Xeomin®) versus onabotulinumtoxinA (Botox®), given the established non-inferiority when utilized at similar doses.MethodsThe Department of Veterans Affairs (VA) and Department of Defense (DoD) national healthcare systems were included in this analysis. Real-world purchase data for incobotulinumtoxinA were used to estimate the direct drug costs between calendar years 2014 and 2019. Publicly available federal pharmaceutical prices (Federal Supply Schedule and Big 4) were used. The primary outcome was the difference in total direct costs nationally for incobotulinumtoxinA (real-world) versus having hypothetically utilized onabotulinumtoxinA (projected) for similar utilization. Sites utilizing ≥100 vials (of 100 Unit equivalents) of incobotulinumtoxinA annually were categorized as “major adopters”. IncobotulinumtoxinA 50 Unit vials were assumed to be an alternative to a 100 Unit vial of onabotulinumtoxinA for 50% of such vial purchases in the base case scenario to account for differences in wastage.ResultsOver the six-year study time frame, 156 sites (76.8%) utilized incobotulinumtoxinA of the 203 total VA healthcare systems and DoD medical centers. Of these sites, 67 were major adopters for at least one year, with a mean of 3.4 years spent as a major adopter over the study period. Average annual savings per major adopter was $105,782. IncobotulinumtoxinA costs for all VA/DoD sites was $46.39 million for the six-year period versus a projected $71.92 million onabotulinumtoxinA cost—a total savings of $25.53 million (35.5% relative reduction). Approximately, 82.8% of savings stemmed from lower drug acquisition cost ($21.14 million) and 17.2% of savings ($4.39 million) was related to reduced wastage. It was estimated that a total of 9958 extra onabotulinumtoxinA 100 Unit vials would have been wasted during the six-year period, translating to the need for a 5.9% increase in vial purchases versus incobotulinumtoxinA.ConclusionMeaningful cost savings were realized related to incobotulinumtoxinA adoption over a long-term time frame in the VA/DoD healthcare systems.