Merz Aesthetics Products: Complete Guide for Aesthetic Practices

Key Takeaways

• Merz Aesthetics is the world's largest dedicated medical aesthetics business, family-owned since 1908, with a commercial presence in 90 countries and a comprehensive portfolio spanning injectables, devices, and skincare.
• All primary Merz aesthetic products are FDA-approved, with Xeomin first approved in August 2010 for therapeutic use and later expanded to cosmetic indications in 2011. In July 2024, Xeomin became the first and only neurotoxin approved for simultaneous treatment of all three upper facial areas.
• Retail pricing typically runs $8–$18 per unit for Xeomin and $650–$1,200 per syringe for Radiesse, offering competitive margins when your purchasing volume supports tiered pricing.
• Merz Aesthetics products for face treatments include both hyaluronic acid fillers (Belotero) and the unique calcium hydroxylapatite biostimulator (Radiesse), offering practitioners flexibility to customize treatment protocols across different facial zones.
• Portrait Care offers tiered pricing, bulk discounts, and streamlined ordering to help clinics source Merz Aesthetics products profitably.

About Merz Aesthetics

When patients walk into your clinic asking for Xeomin or Radiesse by name, they're referencing products from Merz Aesthetics—the world's largest company dedicated exclusively to medical aesthetics, with over 115 years of heritage in skin health.

Merz was founded on March 9, 1908, by Friedrich Merz, a 24-year-old pharmacist and chemist who established his own pharmaceutical production (Chemische Fabrik Merz & Co.) in Frankfurt am Main, Germany. His motto—"Trust yourself, be different, and invent products that are truly needed"—still guides the company today. Remarkably, Merz remains family-owned through the fourth generation.

The company entered the aesthetic medicine market in 2010 with the acquisition of US-based BioForm Medical for EUR 190 million, bringing the flagship product Radiesse into its portfolio. Subsequent acquisitions included Swiss company Anteis (makers of Belotero) in 2013 and Ulthera in 2014 for approximately $600 million, establishing Merz's position in the non-invasive device market.

Today, Merz Aesthetics operates from its global headquarters in Raleigh, North Carolina, USA, under the leadership of CEO Bob Rhatigan. The Merz Group generated revenue of EUR 1.3434 billion in the 2021/22 fiscal year, with approximately 45% of sales generated in the United States. The aesthetics division reported approximately $750 million in annual revenue as of May 2025.

Merz Aesthetics at a Glance

• Parent company: Merz Pharma GmbH & Co. KGaA (family-owned since 1908)
• Founded: March 9, 1908 in Frankfurt am Main, Germany
• Global headquarters: Raleigh, North Carolina, USA
• Primary aesthetic products: Xeomin, Radiesse, Belotero, Ultherapy PRIME
• Market position: World's largest dedicated medical aesthetics business
• Employees: Approximately 3,730 people (2021/22) across the Merz Group
• Geographic reach: Commercial presence in 90 countries worldwide

What Is Merz Aesthetics Known For?

Merz Aesthetics has built its reputation on being a pure-play aesthetics company—unlike competitors who divide their focus across multiple pharmaceutical categories. This singular dedication to aesthetic medicine allows Merz to concentrate all research, development, and support resources on helping practitioners deliver optimal patient outcomes.

The company is particularly recognized for Xeomin's unique "naked" formulation (free of complexing proteins), Radiesse's dual-action biostimulatory properties, and Ultherapy's position as the only FDA-cleared non-invasive lifting treatment with real-time visualization. 

Celebrity ambassadors have helped elevate brand awareness: Gwyneth Paltrow became the first brand ambassador in 2020, Christina Aguilera promoted anti-wrinkle injections in 2023, and Demi Lovato has been featured in the "Beauty on Your Terms" campaign.

What Brands Does Merz Own?

Merz operates three distinct business divisions: Merz Aesthetics, Merz Therapeutics, and Merz Consumer Care. The aesthetics division owns Xeomin (incobotulinumtoxinA), Radiesse (calcium hydroxylapatite filler), the Belotero family of hyaluronic acid fillers, and the Ultherapy/Ultherapy PRIME ultrasound lifting platform. 

Merz Therapeutics develops products for neurological movement disorders using the same botulinum toxin technology. Merz Consumer Care markets the Tetesept and Merz Spezial wellness and beauty brands, primarily in German-speaking countries.

Merz Aesthetics Products List

Merz Aesthetics' product lineup spans three primary categories, each addressing specific treatment needs and patient demographics. Understanding these categories helps you build a service menu that meets demand while maximizing your clinic's profitability.

1. Injectable Neurotoxins

The flagship injectable is Xeomin (incobotulinumtoxinA), the only FDA-approved neurotoxin free of complexing proteins. This purified formulation addresses dynamic wrinkles across all three upper facial areas—the treatments that drive repeat visits and patient loyalty for most med spas.

2. Dermal Fillers & Biostimulators

Merz offers two distinct filler technologies. The Belotero collection provides hyaluronic acid-based fillers utilizing proprietary Cohesive Polydensified Matrix (CPM) technology for natural tissue integration. Radiesse represents the company's biostimulator offering, using calcium hydroxylapatite (CaHA) microspheres to provide immediate volume while stimulating natural collagen production. Results from Radiesse typically last 12–18 months according to clinical studies, making it attractive for patients seeking long-term rejuvenation. Learn more about biostimulator treatments for your practice.

3. Energy-Based Devices

Ultherapy PRIME represents Merz's latest innovation in non-invasive lifting. Acquired in 2014 for approximately $600 million, the Ulthera platform has become the gold standard for non-surgical skin lifting, with over 3.5 million treatments performed worldwide and a 95% patient satisfaction rate at year one, according to Merz clinical data. The newest FDA clearances in November 2025 expanded indications to include arms and abdomen.

What Does Merz Aesthetics Make? Top Products Overview

1. Xeomin (incobotulinumtoxinA)

Xeomin is Merz's flagship neurotoxin, competing directly with BOTOX Cosmetic and Dysport for wrinkle relaxation treatments. First approved by the FDA in August 2010 for therapeutic indications (cervical dystonia and blepharospasm) and expanded to cosmetic use (glabellar lines) in 2011, Xeomin has built a reputation for its unique "naked" formulation.

In July 2024, Xeomin became the first and only FDA-approved neurotoxin for the simultaneous treatment of upper facial lines—forehead lines, frown lines, and crow's feet. The total recommended dose for treatment is 64 units: 20 units for glabellar frown lines, 20 units for horizontal forehead lines, and 24 units for crow's feet.

• Typical retail cost: $8–$18 per unit in the United States
• Average treatment cost: $532 on average, ranging from $294 to $1,000 according to 110 patient reviews
• Clinical use: 64 units for full upper face treatment
• Key differentiator: Purified via XTRACT Technology, removing all complexing proteins
• Storage advantage: Does not require refrigeration before reconstitution—the first botulinum toxin with this feature
• Available vial sizes: 50, 100, or 200 units

Xeomin's lack of complexing proteins may reduce the risk of developing neutralizing antibodies over time—the frequency of this sensitization is reported at around 3% to 10% with traditional botulinum toxin products. For practitioners comparing Merz Aesthetics products to BOTOX alternatives, Xeomin offers a purified option that 90% of surveyed patients say they prefer, knowing it contains only essential ingredients.

2. Radiesse (Calcium Hydroxylapatite)

Radiesse takes a fundamentally different approach to facial rejuvenation. Rather than filling volume with hyaluronic acid, it uses calcium hydroxylapatite (CaHA) microspheres suspended in a gel carrier to provide immediate volume while stimulating your skin's natural collagen production.

• Technology: CaHA microspheres create structural scaffolding for new tissue growth; collagen stimulation begins within 4 weeks
• Results timeline: Immediate volume with full results visible within 7–10 days
• Duration: Results typically last 12–18 months according to clinical studies
• Typical patient cost: $650–$1,200 per 1.5 mL syringe; national average reported at $717 by ASPS
• Syringe size: 1.5 mL standard (larger than most HA filler syringes at 1.0 mL)

Radiesse appeals to patients seeking natural-looking rejuvenation with results that last longer than traditional HA fillers (which typically last 6–12 months). FDA approval covers correction of moderate to severe facial wrinkles and folds (including nasolabial folds). In 2015, the FDA approved Radiesse for the treatment of volume loss in the backs of the hands.

3. Belotero Collection

The Belotero portfolio comprises Merz's hyaluronic acid filler line, which uses proprietary Cohesive Polydensified Matrix (CPM) technology. The first Belotero dermal filler was launched in Germany in 2005, with Belotero Balance receiving FDA approval in November 2011.

Belotero Balance (+) serves as the primary formulation for moderate to severe facial wrinkles and folds, including nasolabial folds. In September 2023, the FDA expanded approval to include correction of hollow areas under the eyes (infraorbital hollows)—making it one of the few fillers indicated explicitly for this delicate area.

• Typical patient cost: $650–$1,000 per syringe
• Duration: Results typically last 6–12 months, depending on the treatment area
• Key advantage: Smooth integration into facial tissue for natural-looking results; lower density makes it better for fine lines than thicker fillers
• Reversibility: Can be dissolved with hyaluronidase if needed
  
  

4. Ultherapy PRIME

Ultherapy represents Merz's energy-based device platform for non-invasive skin lifting, acquired in 2014 for approximately $600 million. The Ulthera System is the only FDA-cleared non-invasive treatment to lift skin on the neck, under the chin, and on the brow, as well as improve lines and wrinkles on the décolletage.

Ultherapy PRIME, launched in September 2024, represents the next generation of this platform. It features enhanced real-time imaging capabilities with a screen 35% larger than the original, delivering 20% faster treatment times according to provider surveys. In November 2025, the FDA cleared Ultherapy PRIME for additional body indications, including the arms and abdomen—making it the only FDA-cleared solution with real-time visualization for the face, neck, décolletage, and body.

• Technology: Microfocused ultrasound with visualization (MFU-V)
• Results timeline: Full results visible in 2–3 months as collagen production increases
• Duration: Results can last up to one year or more
• Clinical backing: Over 120 publications and 3.5 million treatments performed worldwide with 95% patient satisfaction rate
• Device cost: Used Ultherapy machines (2017 models) range from $25,000–$26,000

Merz Aesthetics Products Price List: Wholesale vs. Retail Pricing

Understanding the spread between what you pay and what patients pay determines whether Merz Aesthetics products work for your clinic's economics.

What Clinics Pay (Wholesale)

• Xeomin: $500–$600 per 100-unit vial (approximately $5–$6 per unit)
• Radiesse: $250–$400 per 1.5 mL syringe (varies by volume and supplier)
• Belotero Balance: $150–$250 per syringe (varies by volume and supplier)

What Patients Pay (Typical Retail)

• Xeomin: $8–$18 per unit; average treatment $532 (range $294–$1,000)
• Radiesse: $650–$1,200 per syringe; national ASPS average $717
• Belotero Balance: $650–$1,000 per syringe

The math matters here. If your Xeomin wholesale runs $5.50 per unit and you charge $12, your margin is $6.50 per unit. On a 64-unit complete upper face treatment, the gross margin is $416 per patient. 

At higher volumes with better wholesale pricing, margins improve significantly. That's why your supplier relationship—and the pricing tiers you can access—directly impacts whether Merz Aesthetics products make sense for your practice.

Are Merz Aesthetics Products FDA Approved?

Running an aesthetic clinic means meeting strict regulatory standards. Here's what you need to know about compliance when stocking Merz Aesthetics products.

FDA Approval Status

All primary Merz aesthetic products carry FDA approval or clearance:

Xeomin received initial FDA approval on July 30, 2010, for cervical dystonia and blepharospasm, with cosmetic approval for glabellar lines following in 2011. According to the FDA's approved drugs database, additional indications now include upper limb spasticity, chronic sialorrhea, and, as of July 2024, simultaneous treatment of all upper facial lines.

Radiesse holds FDA approval for the correction of moderate to severe facial wrinkles and folds, including nasolabial folds. In 2015, the FDA expanded approval to include treatment of volume loss in the back of the hands. Radiesse (+) received approval for improving moderate-to-severe loss of jawline contour in adults aged 21 and older.

Belotero Balance received FDA approval on November 16, 2011, for the correction of moderate-to-severe facial wrinkles and folds. The FDA expanded indications in September 2023 to include the correction of hollow areas under the eyes.

Ultherapy PRIME is FDA-cleared to lift skin on the neck, eyebrow, and under the chin, as well as improve lines and wrinkles on the décolletage. As of November 2025, the FDA cleared it to improve the appearance of skin laxity on the anterior arms, posterior arms, and abdomen.

Practitioner Licensing Requirements

Licensing requirements vary by state and treatment type. Generally:

Injectables (Xeomin, Radiesse, Belotero) require administration by licensed physicians, nurse practitioners, or physician assistants under physician supervision. Some states allow licensed RNs to inject under specific protocols, but medical oversight remains essential.

Ultherapy treatments similarly require appropriate medical supervision and state-specific credentialing for the administering practitioner.

How Long Do Merz Aesthetics Filler Results Last?

Duration varies by product and individual patient factors:

• Xeomin: 3–6 months; median first onset of effect is less than a week, maximum effect occurs around 30 days
• Radiesse: 12–18 months according to clinical studies; collagen stimulation effects continue beyond the initial filler absorption
• Belotero Balance: 6–12 months, depending on treatment area
• Ultherapy: Results can last up to one year or more, with effects building over 2–3 months post-treatment

Merz Aesthetics Reviews: Pros, Cons, and Best Fit

Advantages of Merz Aesthetics Products

• Purified neurotoxin formulation means Xeomin's lack of complexing proteins may reduce the risk of antibody formation over time (reported at 3–10% with traditional products), potentially making it suitable for long-term patients who haven't responded to other neurotoxins.
• Biostimulatory filler technology in Radiesse provides dual benefits—immediate volume correction plus ongoing collagen stimulation—offering results lasting 12–18 months versus 6–12 months for traditional HA fillers.
• Room-temperature storage for Xeomin before reconstitution simplifies inventory management and reduces cold-chain logistics compared to competitors requiring refrigeration.
• First-to-market innovations, including the only neurotoxin approved for simultaneous upper facial treatment (July 2024) and the only non-invasive lifting device with real-time visualization, provide marketing differentiation.
• Pure-play aesthetics focus means that all company resources are dedicated to aesthetic medicine rather than being divided across pharmaceutical categories.
• Strong clinical backing with Ultherapy supported by over 120 publications and over 3.5 million treatments performed worldwide.

Disadvantages of Merz Aesthetics Products

• Lower brand recognition than BOTOX means some patients specifically request the Allergan brand, which has approximately 80% of the botulinum toxin type A market. Converting these patients requires educating them about equivalent results and the benefits of Xeomin's purified formulation.
• Radiesse is not reversible, unlike hyaluronic acid fillers that can be dissolved with hyaluronidase. This requires a more careful injection technique and patient counseling.
• Smaller filler portfolio compared to competitors like Galderma (Restylane with 27+ years of clinical data) or Allergan (JUVÉDERM), which offer more formulation variety for different treatment zones.
• FDA warning history included a November 2024 reprimand for misleading Instagram advertising featuring Nate Berkus promoting Xeomin; the FDA cited claims about rapid effects and unique benefits lacking supporting data. This highlights the importance of compliant marketing practices.

Best Fit for Merz Aesthetics Products

Merz Aesthetics products work well for:

• Practices seeking a purified neurotoxin alternative for patients who may have developed resistance to other formulations
• Clinics wanting biostimulatory options that provide longer-lasting results (12–18 months) than traditional HA fillers (6–12 months)
• Practices interested in non-invasive lifting treatments backed by extensive clinical evidence (120+ publications)
• Multi-service clinics looking to offer combination treatments with injectables and devices from a single manufacturer
• Growing aesthetics practices prioritizing products with strong clinical support and training resources

Merz Aesthetics products may not be ideal for:

• Practices where patients exclusively demand BOTOX or JUVÉDERM by name
• Clinics seeking the broadest filler portfolio from a single manufacturer
• Practitioners who want reversible options for all filler applications

Alternatives to Merz Aesthetics Products

Understanding your options helps you build a product mix that balances brand recognition, margin requirements, and patient preferences.

Injectable Alternatives

• BOTOX Cosmetic (onabotulinumtoxinA) remains the most recognized neurotoxin brand globally with approximately 80% market share. Higher per-unit cost ($10–$20/unit retail vs. $8–$18 for Xeomin) but carries unmatched brand awareness.
• Dysport (abobotulinumtoxinA) from Galderma offers broader diffusion characteristics that some practitioners prefer for larger treatment zones. Retail pricing $4–$8 per unit, but requires more units (approximately 2.5–3 Dysport units per 1 BOTOX unit).
• JUVÉDERM Collection (Allergan/AbbVie) competes directly with Belotero. The VYCROSS technology offers different handling characteristics that some injectors prefer. Strong brand awareness but typically higher wholesale costs.
• Restylane Collection (Galderma) offers the world's most diverse HA filler portfolio, backed by over 27 years of clinical data.
• Sculptra (poly-L-lactic acid) from Galderma provides biostimulation similar to Radiesse, but with gradual results that develop over several months rather than immediate volume.

Why Practitioners Choose Alternatives

Brand recognition drives many decisions—BOTOX and JUVÉDERM command premium positioning, simplifying patient acquisition. Some patients respond better to specific formulations, making diversification clinically valuable. And exclusive agreements with manufacturers can provide preferential pricing for committed practices.

How to Choose the Right Products

Step 1: Define Your Clinical Niche

Start by identifying your target patient demographic and treatment focus. Are you a full-service aesthetic clinic or a specialist focused on specific treatments? Do you serve patients seeking premium, purified formulations? What's your practitioner expertise—dermatology, plastic surgery, or nursing background? Your answers shape which products make sense for your practice.

Step 2: Evaluate Your Practice Economics

Calculate realistic margins for each product, including wholesale cost vs. retail pricing in your specific market, patient volume needed to access favorable pricing tiers, storage and handling requirements, and staff training investments.

If Xeomin wholesale runs $5.50 per unit and you charge $12, your margin is $6.50 per unit. On a 64-unit treatment (the recommended full upper face dose per the FDA labeling), that's a gross margin of $416 per patient. Understanding your economics prevents costly inventory decisions.

Step 3: Assess Market Demand in Your Geography

Research competitor pricing and patient preferences in your area. Urban areas like California average $18/unit for neurotoxins, versus Midwest states averaging $12/unit. Markets with established BOTOX dominance may require education to convert patients to Xeomin. 

Step 4: Consider Training and Support

Merz provides extensive training through programs like the Merz Aesthetics Expert Summit (MEXS), established in 2011 to bring together healthcare professionals from around the world—the 2024 summit attracted attendees from 50 countries. 

The company also offers the Merz Scales, a validated rating and communication tool for evaluating aesthetic signs of aging. For practitioners building aesthetic training credentials, manufacturer-supported education represents valuable professional development.

Step 5: Test Before Committing

Order sample quantities of products you're considering and train staff on application and patient education. Track patient satisfaction, retention, and repeat booking rates. 

Xeomin has a 95% Worth It Rating on RealSelf, based on patient reviews. Monitor wholesale pricing stability over 3–6 months before making significant inventory commitments.

Step 6: Build Your Product Mix

Most successful practices use a hybrid approach: one or two neurotoxins and one primary filler brand as core products, with alternatives available for patients who prefer specific brands. 

Adding professional skincare extends patient relationships and increases lifetime value. Learn how to conduct expert consultations that help patients choose the right treatments.

Buy Merz Aesthetics Products with Portrait Care

Your purchasing strategy determines whether premium products generate premium margins or squeeze your profitability. Assess your practice's volume needs and growth trajectory—this determines your pricing tier and negotiating leverage.

As you grow, revisit your supplier relationships quarterly. Review purchasing patterns, evaluate product performance against patient demand, and renegotiate terms as you move into higher-volume brackets. The difference between good and excellent supplier relationships often shows up directly on your bottom line.

If you're ready to stock Merz Aesthetics' market-leading portfolio, Portrait Care provides the infrastructure, pricing advantages, and operational support needed to do it profitably.

Portrait Care offers:

• Tiered pricing based on monthly purchase volume
• Bulk discounts for clinics ordering large quantities
• Standing order programs for predictable products like monthly Xeomin shipments
• Online ordering portal for convenience and real-time inventory tracking
• Expert guidance on building a product mix that serves your patients and your margins

Whether you're launching a new aesthetics clinic or expanding an established practice, Portrait Care can help you source Merz Aesthetics products at competitive wholesale pricing while providing the operational support you need to succeed.

Speak to Portrait Care today.