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Ormseth BH, ElHawary H, Janis JE. The Fragility of Landmark Randomized Controlled Trials in the Plastic Surgery Literature. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5352. [PMID: 38235350 PMCID: PMC10793969 DOI: 10.1097/gox.0000000000005352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/24/2023] [Indexed: 01/19/2024]
Abstract
Background Randomized controlled trials (RCTs) are integral to the progress of evidenced-based medicine and help guide changes in the standards of care. Although results are traditionally evaluated according to their corresponding P value, the universal utility of this statistical metric has been called into question. The fragility index (FI) has been developed as an adjunct method to provide additional statistical perspective. In this study, we aimed to determine the fragility of 25 highly cited RCTs in the plastic surgery literature. Methods A PubMed search was used to identify the 25 highest cited RCTs with statistically significant dichotomous outcomes across 24 plastic surgery journals. Article characteristics were extracted, and the FI of each article was calculated. Additionally, Altmetric scores were determined for each study to determine article attention across internet platforms. Results The median FI score across included studies was 4 (2-7.5, interquartile range). The two highest FI scores were 208 and 58, respectively. Four studies (16%) had scores of 0 or 1. Three studies (12%) had scores of 2. All other studies (72%) had FI scores of 3 or higher. The median Altmetric score was 0 (0-3). Conclusion The FI can provide additional perspective on the robustness of study results, but like the P value, it should be interpreted in the greater context of other study elements.
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Affiliation(s)
- Benjamin H. Ormseth
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Hassan ElHawary
- Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Canada
| | - Jeffrey E. Janis
- From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Wu Y, Fang F, Lai W, Li C, Li L, Liu Q, Lu J, Pang X, Sun J, Shi X, Picaut P, Prygova I, Andriopoulos B, Sun Q. Efficacy and Safety of AbobotulinumtoxinA for the Treatment of Glabellar Lines in Chinese Patients: A Pivotal, Phase 3, Randomized, Double-Blind and Open-Label Phase Study. Aesthetic Plast Surg 2023; 47:351-364. [PMID: 36536093 PMCID: PMC9944721 DOI: 10.1007/s00266-022-03164-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Various botulinumtoxinA formulations are approved for glabellar lines treatment worldwide, including abobotulinumtoxinA (Dysport®). OBJECTIVES Assess abobotulinumtoxinA superiority versus placebo and non-inferiority versus active comparator (onabotulinumtoxinA; Botox®), for the treatment of Chinese patients with moderate/severe glabellar lines. METHODS Phase 3, randomized study (NCT02450526) comprising a double-blind (cycle 1) phase and an open-label (cycles 2-5) phase. Patients received abobotulinumtoxinA 50 units or matching placebo (5:1), active comparator (onabotulinumtoxinA 20 units) or matching placebo (5:1). In cycles 2-5, eligible patients were retreated with abobotulinumtoxinA only. Responders had glabellar lines of none/mild severity. PRIMARY ENDPOINT responder rates at cycle 1, day 29 at maximum frown with abobotulinumtoxinA versus placebo (for superiority; by investigator's live assessment [ILA] and subject's self-assessment [SSA]), and versus active comparator (for non-inferiority; by ILA). Treatment-emergent adverse events were recorded. RESULTS Overall, 520 patients were randomized. Superiority and non-inferiority, respectively, were demonstrated for abobotulinumtoxinA versus placebo (ILA, SSA; both p < 0.0001) and abobotulinumtoxinA versus active comparator. AbobotulinumtoxinA efficacy was maintained over open-label cycles; median time to onset of efficacy was 2.0 days. After 6 months, 17% of patients treated with abobotulinumtoxinA remained responders. AbobotulinumtoxinA was well-tolerated. Safety results were in line with the known profile of abobotulinumtoxinA; adverse events rate decreased with repeated treatment. CONCLUSIONS After a single injection, abobotulinumtoxinA demonstrated superiority versus placebo and non-inferiority versus onabotulinumtoxinA for the treatment of moderate-to-severe glabellar lines in Chinese patients. Multiple injections of abobotulinumtoxinA demonstrated efficacy and safety in the treatment of glabellar lines in Chinese patients. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yan Wu
- Peking University First Hospital, No. 8 Xishiku Street, Xicheng, Beijing, 100034, China.
| | - Fang Fang
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China
| | - Wei Lai
- Department of Dermatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Chengxin Li
- General Hospital of People's Liberation Army (301 Hospital), Beijing, China
| | - Li Li
- West China Hospital, Sichuan University, Chengdu, China
| | - Quanzhong Liu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Jianyun Lu
- Third Xiangya Hospital of Central South University, Changsha, China
| | | | - Jiaming Sun
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | | | | | | - Qiuning Sun
- Peking Union Medical College Hospital, Beijing, China
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Efficacy and Safety of Botulinum Toxin Type A for Treatment of Glabellar Lines: A Network Meta-Analysis of Randomized Controlled Trials. Aesthetic Plast Surg 2023; 47:365-377. [PMID: 36097079 DOI: 10.1007/s00266-022-03018-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/06/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Botulinum toxin type A (BoNT/A) has been used in aesthetic applications worldwide, including glabellar lines. Currently, four BoNT/A preparations were approved for the improvement of moderate-to-severe glabellar lines: onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, and prabotulinumtoxinA. DaxibotulinumtoxinA is a new form of BoNT/A drug that is developed in clinical application. We performed this network meta-analysis (NMA) to assess the efficacy and safety of all these different BoNT/A formulations for treating glabellar lines. METHODS The investigators searched randomized controlled trials (RCTs) using the Medical Subject Headings (MeSH) terms "botulinum toxin" and "glabellar lines." We searched the relevant studies in electronic databases as following: PubMed, Elsevier, EMBASE and the Cochrane Library. The end points included the percentage of subjects with a glabellar line severity (GLS) score of none (0) or mild (1), and the percentage of subjects achieving ≥ 1-point and 2-point improvement in glabellar line severity at maximum frown at approximately month 1 by the investigators' assessment. RESULTS All formulations of BoNT/A were far superior to placebo in efficacy. DaxibotulinumtoxinA was the only treatment that significantly increased the proportion of subjects achieving ≥ 1 point improvement in GLS score compared with other BoNT/A formulations. Moreover, daxibotulinumtoxinA was ranked the highest for the proportion of subjects achieving ≥ 2-point improvement in GLS score. No significant differences were revealed for the incidence of any adverse events (AEs) that related to treatment or drug among all BoNT/A preparations. CONCLUSION The overall results of this NMA suggested that daxibotulinumtoxinA is a new BoNT/A preparation that may be not only more effective but also well-tolerated for the treatment of glabellar lines. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Liquid AbobotulinumtoxinA: Pooled Data From Two Double-Blind, Randomized, Placebo-Controlled Phase III Studies of Glabellar Line Treatment. Dermatol Surg 2022; 48:1198-1202. [PMID: 36206385 PMCID: PMC9632942 DOI: 10.1097/dss.0000000000003594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AbobotulinumtoxinA (aboBoNT-A) solution is a new ready-to-use formulation developed to reduce preparation time and improve reproducibility of injections. OBJECTIVE To further evaluate treatment of moderate-to-severe glabellar lines (GLs) using pooled data from 2 Phase III studies. METHODS Following double-blind treatment with 50 U aboBoNT-A solution (n = 251) or placebo (n = 123), GL severity was assessed by investigators (ILA) and subjects (SSA). Other assessments included subject-reported time to onset, subject satisfaction, FACE-Q, and adverse events. RESULTS One month after aboBoNT-A solution treatment, 88% had none-or-mild GLs at maximum frown and 93% had ≥1-grade improvement in ILA (similar for SSA), 24% to 27% remaining improved at Month 6. Glabellar lines responder rates remained higher than placebo throughout Month 6 ( p < .001). Almost two-thirds of subjects reported onset within 3 days, nearly a quarter reporting effect by Day 1. Subject satisfaction with GL appearance, and FACE-Q satisfaction with facial appearance overall and psychological well-being were also improved over placebo throughout Month 6, p < .05. Treatment-related adverse events were nonserious and mild or moderate. CONCLUSION Pooled analysis confirmed a duration of effect on GLs of up to 6 months for aboBoNT-A solution, with onset starting within 24 hours, high subject satisfaction, and improved psychological well-being. The treatment was well tolerated.
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Dayan S, Joseph J, Moradi A, Lorenc ZP, Coleman K, Ablon G, Kaufman-Janette J, Cox SE, Campbell A, Munavalli G, Prygova I. Subject Satisfaction and Psychological Well-being with Escalating AbobotulinumtoxinA Injection Dose for the Treatment of Moderate to Severe Glabellar Lines. J Cosmet Dermatol 2022; 21:2407-2416. [PMID: 35266281 PMCID: PMC9322427 DOI: 10.1111/jocd.14906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Background Previous studies indicate that the efficacy and durability of a single AbobotulinumtoxinA (ABO) treatment for moderate to severe glabellar lines may be enhanced with increasing dose, while safety outcomes remain consistent with those of the licensed dose (50 U). Aims Evaluation of subject‐reported indicators of treatment efficacy, satisfaction, and psychological well‐being with ABO dose escalation. Methods A Phase 2, 36‐week, multicenter, randomized, dose‐ranging, double‐blind, placebo‐controlled study was conducted in adults with moderate to severe glabellar lines. Subjects received a single ABO treatment, dosed at 50, 75, 100, or 125 U, or placebo. Efficacy endpoints comprised subject‐assessed improvement in line severity of ≥1‐grade from baseline at maximum frown, global aesthetic improvement scale (GAIS) grade, FACE‐Q™ appraisal of lines, psychological well‐being and age, and subject satisfaction. Results The study included 399 subjects (88.2% were female). Respective responder rates (≥1‐grade improvement) with ABO 50–125 U doses ranged between 96.3%–100% at Week 4, 65.0%–67.9% at Week 24, and 33.8%–44.4% at Week 36. GAIS responder rate and FACE‐Q appraisal of lines showed a similar pattern of change. Satisfaction was high and psychological well‐being was improved from Week 4 through Week 36, with natural, youthful, and refreshed appearance reported for all ABO doses. Conclusions A single ABO treatment (dosed at 50–125 U) provided significant and sustained improvements in glabellar line severity over durations up to 36 weeks, versus placebo. Treatment satisfaction was high with all doses. Participants reported natural and youthful appearance, alongside improvements in psychological well‐being.
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Affiliation(s)
| | - John Joseph
- Clinical Testing of Beverly Hills, Encino, CA, USA
| | | | - Z Paul Lorenc
- Lorenc Aesthetic Plastic Surgery Center, New York, USA
| | - Kyle Coleman
- Etre Cosmetic Dermatology and Laser Center, New Orleans, LA, USA
| | - Glynis Ablon
- Ablon Skin Institute and Research Center, Manhattan Beach, CA, USA
| | | | | | | | - Girish Munavalli
- Dermatology, Laser & Vein Specialists of the Carolinas, PLLC, Charlotte, NC, USA
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Kaufman-Janette J, Cox SE, Dayan S, Joseph J. Botulinum Toxin Type A for Glabellar Frown Lines: What Impact of Higher Doses on Outcomes? Toxins (Basel) 2021; 13:494. [PMID: 34357966 PMCID: PMC8310242 DOI: 10.3390/toxins13070494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
Botulinum toxin serotype-A (BoNT-A) preparations are widely used to improve the appearance of wrinkles. While effective and well tolerated, patients require retreatment over time to re-establish the effects. There is growing interest from patients as to whether higher doses can prolong response without significantly increasing side effects. We reviewed the efficacy and safety evidence for high-dose BoNT-A treatment of glabellar lines, by evaluating high-dose studies published since 2015. Toxins approved for glabellar line treatment in the US or Europe were considered. "High-dose" indicated doses above the licensed dose for each BoNT-A preparation. Five studies met the inclusion criteria and most were randomized, double-blind trials; designs and population sizes varied. Findings suggested that higher-dose BoNT-A treatment is feasible and may improve response duration without increased safety issues. Around 9 months' median duration was achieved with a 2-2.5-fold increase of the abobotulinumtoxinA on-label dose, or with a 5-fold increase in incobotulinumtoxinA dose. A 2-4-fold increase of the onabotulinumtoxinA on-label dose yielded a median duration of around 6 months. Importantly, patient satisfaction and natural look remained with increasing abobotulinumtoxinA doses. While more data are needed, these findings may lead to more effective, individually tailored treatment plans to meet patient expectations.
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Affiliation(s)
- Joely Kaufman-Janette
- Skin Associates of South Florida, Skin Research Institute, 4425, Ponce De Leon Boulevard, Suite 200, Coral Gables, FL 33146-1871, USA
| | | | | | - John Joseph
- Clinical Testing of Beverly Hills, Encino, CA 91436, USA;
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Patil A, Kassir M, Wollina U, Goldust M. [New botulinum toxins for aesthetic dermatology : A comprehensive review]. Hautarzt 2021; 72:393-402. [PMID: 33822278 DOI: 10.1007/s00105-021-04801-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
Facial rejuvenation is gaining immense popularity among patients and clinicians. Botulinum toxins derived from bacteria are well-tolerated options as minimally invasive interventions for facial rejuvenation or other aesthetic procedures. These products have revolutionized aesthetic treatments. Several types of botulinum toxins (BoNT) are available. Currently type A and B are clinically used and only BoNT‑A products are approved for use for cosmetic indications in the Germany and the United States. Each product is unique in terms of its composition. Understanding the various BoNT‑A products is essential in choosing the optimal treatment for our patients. In this article we discuss different BoNT‑A products used for aesthetic intervention.
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Affiliation(s)
- A Patil
- Department of Pharmacology, Dr DY Patil Medical College, Navi Mumbai, India
| | - M Kassir
- Worldwide Laser Institute, Dallas, USA
| | - U Wollina
- Klinik für Dermatologie und Allergologie, Städtisches Klinikum Dresden, Dresden, Deutschland
| | - M Goldust
- Universitäts-Hautklinik, University Medical Center Mainz, Johannes Gutenberg-Universität, Langenbeckstr.1, 55131, Mainz, Deutschland.
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Schlessinger J, Cohen JL, Shamban A, Jacob C, Karimi K, Maas C, Lane V, Coquis-Knezek S, Meckfessel M. A Multicenter Study to Evaluate Subject Satisfaction With Two Treatments of AbobotulinumtoxinA a Year in the Glabellar Lines. Dermatol Surg 2021; 47:504-509. [PMID: 33165057 PMCID: PMC8021233 DOI: 10.1097/dss.0000000000002846] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Real-world re-treatment intervals for botulinum toxins vary, but most subjects receive treatment less frequently than the manufacturer-recommended minimum intervals. In subjects receiving treatment with AbobotulinumtoxinA (ABO) less frequently, high levels of satisfaction and psychosocial improvements in well-being, self-confidence, and quality of life are observed. OBJECTIVE To evaluate subject satisfaction with a twice yearly re-treatment schedule. METHODS AND MATERIALS This open-label, multicenter, interventional study evaluated subject satisfaction following injections of ABO 50 U in the glabellar lines at baseline and 6 months. The primary end point was subject satisfaction at 12 months. Secondary endpoints included subject satisfaction, FACE-Q scales, and glabellar line severity scale (GLSS). RESULTS Ninety-five percent of the 120 subjects were "highly satisfied" or "satisfied" with their treatment outcomes at 12 months. FACE-Q total scores suggested that subjects were less bothered by glabellar lines and felt better about their facial appearance with each treatment versus baseline. Approximately half of subjects had ≥1-grade improvement from baseline in GLSS at 12 months. Median onset of effect was 2 days. CONCLUSION The majority of subjects (95%) were satisfied with ABO treatment every 6 months; results were supported by high subject satisfaction, long duration, rapid onset, natural-looking results, and overall psychological wellness and safety.
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Affiliation(s)
| | | | - Ava Shamban
- Advanced Skin Research Center
- University of California Irvine
- Chicago Cosmetic Surgery and Dermatology
- Rejuva Medical Aesthetics, Inc
- University of California San Francisco
- Medsense Ltd
- Galderma Laboratories
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Smit R, Gubanova E, Kaufman J, Landau M, Molina B, Andriopoulos B, Maisonobe P, Prygova I, Redaelli A. Patient Satisfaction with AbobotulinumtoxinA for Aesthetic Use in the Upper Face: A Systematic Literature Review and Post-hoc Analysis of the APPEAL Study. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:E69-E88. [PMID: 34221231 PMCID: PMC8211347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND: AbobotulinumtoxinA (AboBoNT-A; Dysport®; Ipsen, Boulogne-Billancourt, France/Azzalure®; Galderma, Lausanne, Switzerland) is a botulinum neurotoxin type A approved for aesthetic use in the treatment of glabellar lines in adult patients under 65 years in Europe, the United States, and other countries. OBJECTIVE: We sought to analyze current literature on patient satisfaction with aboBoNT-A for upper facial aesthetic indications. METHODS: A systematic review of literature databases (PubMed/MEDLINE, Embase, the Cochrane Library, and Google Scholar) was performed to identify English-language publications reporting on patients with aesthetic indications (including glabellar lines and wrinkles) receiving aboBoNT-A, that assessed patient and/or physician satisfaction with treatment, with no restrictions on comparator studies. Structured data extraction was used to enable inter-study analysis. A post-hoc analysis was also performed to assess patient satisfaction by sex and age, using results from the noninterventional APPEAL study of patients' satisfaction with aboBoNT-A for treating glabellar lines. RESULTS: Overall, 22 original research papers were identified. Patient satisfaction rates for aboBoNT-A treatment were significantly higher versus placebo from two weeks to between three and five months postinjection. At two to three weeks postinjection, patient satisfaction rates were 52% and 99% across studies. In studies with later time points, patient satisfaction rates were 85 to 87 percent at 5 months and between 25 and 100 percent at 6 months post-injection. Physician satisfaction was also high (97%-100%, across three treatments). No notable differences in patient satisfaction by sex or age were observed in the APPEAL study. CONCLUSION: High rates of patient satisfaction have been achieved with aboBoNT-A treatment for upper facial aesthetic indications. Despite the current recommended interval of ≥12 weeks, satisfaction with the aesthetic results of aboBoNT-A therapy is still evident up to 6 months post-injection in some patients.
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Affiliation(s)
- Riekie Smit
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Elena Gubanova
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Joely Kaufman
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Marina Landau
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Beatriz Molina
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Bill Andriopoulos
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Pascal Maisonobe
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Inna Prygova
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
| | - Alessio Redaelli
- Dr. Smit is with the Dr. Riekie Smit Aesthetic Medical Practice in Pretoria, South Africa
- Dr. Gubanova is with Vallex Med Clinic of Preventive Medicine, Moscow National University of Food Production in Moscow, Russian Federation
- Dr. Kaufman is with the University of Miami, Miller School of Medicine and Skin Associates of South Florida in Coral Gables, Florida, United States of America
- Dr. Landau is with Wolfson Medical Center in Holon, Israel
- Dr. Molina is with Medikas Medispa in Street, Somerset, United Kingdom
- Dr. Andriopoulos is with Galderma Aesthetics in Uppsala, Sweden. Mr. Maisonobe and Dr. Prygova are with Ipsen Pharma, Boulogne-Billancourt, France
- Dr. Redaelli is with the Visconti di Modrone Medical Center in Milan, Italy
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Krasilnikova O, Pozdnyakova M. Innovative approach to aesthetical medicine services quality assessment. J Cosmet Dermatol 2020; 20:636-646. [PMID: 32614990 DOI: 10.1111/jocd.13584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022]
Abstract
Recently, both doctors and patients pay particular attention to aesthetic medical services quality and efficacy of aesthetic adjustment implemented. It is essential to ensure research, analysis, and improving of botulinum toxin therapy quality and provide patients' orientation on the adjustment schedule, which includes long-term observation period, in order to accomplish the expected goals and increase degree of satisfaction. Injections of medication such as botulinum A toxin are highly demanded in many types of aesthetic treatment. However, practically, sufficient cosmetological effect may not always be achieved, and moreover, complications are possible. This article presents an attempt to evaluate botulinum toxin therapy efficacy using computer program, with calculation of integral quality factor (IQF) and plotting injection modeling visual diagram in long-term observation period. In 3 selected clinical examples, aggregate IQF figure makes: in case of static forehead wrinkles 91.67%, for dynamic forehead wrinkles 76.67%; in case of static eyebrow wrinkles 96.67%, for dynamic eyebrow wrinkles 85%; as applied to static wrinkles of the outer corned of the eye 91.67%, whereas applied to dynamic wrinkles of the outer corner of the eye 73.33%. Although the benchmark is thought to be 100% of remodeling result, the procedures outcome still meets patients' expectations. At the same time, present approach demands further discussion and collection for the purpose of development of procedural basis for aesthetic services quality assessment and interpretation of findings.
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Affiliation(s)
- Olga Krasilnikova
- Privolzhsky Research Medical University of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russian Federation
| | - Marina Pozdnyakova
- Department of Medical and Preventive Technologies for Public Health Risk Management, Nizhny Novgorod Research Institute of Hygiene and Occupational Pathology of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Nizhny Novgorod, Russian Federation
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Warren H, Welch K, Coquis-Knezek S. AbobotulinumtoxinA for Facial Rejuvenation: What Affects the Duration of Efficacy? Plast Surg Nurs 2020; 40:37-44. [PMID: 32102079 DOI: 10.1097/psn.0000000000000292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AbobotulinumtoxinA (Dysport) has a long history as a safe and effective treatment option for aesthetic rejuvenation. One of the key measures of botulinum toxin efficacy is the persistence of clinically meaningful results. The duration of efficacy depends on different factors, many of which can be controlled by the clinician to better achieve their desired results. In this review, we discuss how dose, individual patient variation, and injection technique affect the duration of botulinum toxins. Increased duration may result from increased dose or more precise placement of the toxin in the muscle. The varying anatomy and behavior of patients can affect duration as well. Measures of duration in clinical studies vary, but both a 1-grade improvement on the glabellar line severity scale and patient-reported outcomes are key measures. The clinical effects of Dysport can last up to 5 months, and patients in Dysport clinical studies remained satisfied with treatment for up to 6 months. Dysport has a legacy of safety, efficacy, and high subject satisfaction demonstrated through studies and clinical experience. Building on that legacy by correctly dosing the subject, properly accounting for the individual subject anatomy and behavior, and using specific injection techniques can help ensure that your patients have the longest lasting results.
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Affiliation(s)
- Hermine Warren
- Hermine Warren, DNP, APRN, CANS, CNM, is an advanced practice RN, GenNow faculty and a GAIN trainer for Galderma. She is also PALETTE faculty. She is at Facialogy Medical, Inc., Encino, CA
- Kim Welch, BSN, RN, CANS, is an aesthetics specialist GenNow faculty and a GAIN trainer for Galderma. She is at Esperance Aesthetic Wellness, Coppell, TX
- Sarah Coquis-Knezek, PhD, is an associate medical affairs advisor at Galderma Laboratories, L.P., Fort Worth, TX
| | - Kim Welch
- Hermine Warren, DNP, APRN, CANS, CNM, is an advanced practice RN, GenNow faculty and a GAIN trainer for Galderma. She is also PALETTE faculty. She is at Facialogy Medical, Inc., Encino, CA
- Kim Welch, BSN, RN, CANS, is an aesthetics specialist GenNow faculty and a GAIN trainer for Galderma. She is at Esperance Aesthetic Wellness, Coppell, TX
- Sarah Coquis-Knezek, PhD, is an associate medical affairs advisor at Galderma Laboratories, L.P., Fort Worth, TX
| | - Sarah Coquis-Knezek
- Hermine Warren, DNP, APRN, CANS, CNM, is an advanced practice RN, GenNow faculty and a GAIN trainer for Galderma. She is also PALETTE faculty. She is at Facialogy Medical, Inc., Encino, CA
- Kim Welch, BSN, RN, CANS, is an aesthetics specialist GenNow faculty and a GAIN trainer for Galderma. She is at Esperance Aesthetic Wellness, Coppell, TX
- Sarah Coquis-Knezek, PhD, is an associate medical affairs advisor at Galderma Laboratories, L.P., Fort Worth, TX
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