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Yener A, Acharya V, Andrews P, Meller C, Shamil E. The Role of Botulinum Toxin A Neuromodulator in the Management of Synkinesis in Facial Palsy. Facial Plast Surg 2024. [PMID: 39038799 DOI: 10.1055/a-2370-2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024] Open
Abstract
Facial palsy describes the denervation of the facial nerve leading to difficulty in facial animation and expression. Facial synkinesis is the result of complex pathological nerve regeneration following damage to the facial nerve axons. Synkinesis in facial palsy can be managed using facial neuromuscular rehabilitation, botulinum toxin neuromodulators, and surgical treatment options. Botulinum toxin A can be used as an adjunct to other treatment options to manage synkinesis. This article will explore the role of botulinum toxin A in the management of synkinesis in facial palsy including the clinical assessment, injection location (muscles targeted), dosages, treatment interval, and long-term results. It will also include surgical management options.
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Affiliation(s)
- Asalet Yener
- Division A, Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Vikas Acharya
- Royal National ENT and EDH/UCLH and National Hospital of Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Peter Andrews
- Royal National ENT and EDH/UCLH and National Hospital of Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Catherine Meller
- Post Graduate Clinical Training at Prince of Wales Hospital, Sydney, Australia
| | - Eamon Shamil
- Facial Reanimation and Facial Plastic and Reconstructive Surgery, Prince of Wales Hospital, Sydney, Australia
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2
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Shamil E, Noriega M, Moin S, Ko TK, Tan DJY, Meller C, Andrews P, Lekakis G. Psychological Aspects of Facial Palsy. Facial Plast Surg 2024; 40:433-440. [PMID: 38648794 DOI: 10.1055/s-0044-1782678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
This article discusses the psychological effects of facial palsy (FP) in adults. FP is the abnormal functioning of facial muscles resulting from temporary or permanent damage of the facial nerves. Following facial paralysis, patients can develop motor and psychosocial functioning issues impacting quality of life. In addition, real or perceived judgment in social settings of those with FP increases the risk of low self-esteem, anxiety, and depression. Currently, most available research focuses on surgical patients and suggests a lack of psychological support throughout the affliction. A multidisciplinary approach when treating patients with FP can help improve the patient's quality of life.
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Affiliation(s)
- Eamon Shamil
- Department of ENT Surgery, Prince of Wales Hospital, Sydney, Australia
- Department of ENT Surgery, The Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Maria Noriega
- Department of ENT Surgery, The Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Sarah Moin
- Department of ENT Surgery, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, United Kingdom
| | - Tsz Ki Ko
- Department of ENT Surgery, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Denise Jia Yun Tan
- Department of ENT Surgery, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Catherine Meller
- Department of ENT Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Peter Andrews
- Department of ENT Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
| | - Garyfalia Lekakis
- Department of ENT Surgery, Hôpitaux Iris Sud HIS, Brussels, Belgium
- University Hospitals Leuven, Leuven, BE, Louise Medical Center, Bruxelles, Belgium
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3
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Liu RH, Yau J, Derakhshan A, Xiao R, Hadlock TA, Lee LN. Facial Filler in Facial Paralysis: A Prospective Case Study and Multidimensional Assessment. Facial Plast Surg Aesthet Med 2024; 26:426-430. [PMID: 37428541 DOI: 10.1089/fpsam.2023.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Background: Facial filler is emerging as a nonsurgical alternative for addressing static asymmetry in facial paralysis (FP). Objectives: To elucidate the patient experience for facial filler and to facilitate preprocedure counseling and education. Materials and Methods: Patients receiving hyaluronic acid filler for FP at a tertiary academic medical center were prospectively recruited. Primary outcomes included patient-reported pain, facial symmetry (on a visual analog scale), and the results of quality-of-life surveys (FACE-Q satisfaction with facial appearance [SFA], FACE-Q psychosocial distress [PSD], Patient Health Questionnaire-9 [PHQ-9], and Euro Quality of Life 5-Dimension [EQ5D]) preprocedure and at 1 and 14 days postprocedure. Results: Twenty patients (90% women, average age 55 ± 11) completed the study. Sites of filler included the cheek, lower lip, nasolabial fold, chin, and temple regions. Patients reported minimal pain at postprocedure days (PPDs) 1 and 14. Patient-perceived symmetry scores improved significantly (p < 0.0001), as did FACE-Q SFA and FACE-Q PSD scores (p < 0.0001, <0.0001) when comparing preprocedure with PPD 14. Depression, assessed by PHQ-9, and the anxiety/depression domain of EQ5D, decreased after treatment (p = 0.016, 0.014) but no change was observed in the other domains of EQ5D. Conclusion: Facial filler for FP can be performed with minimal morbidity (pain, impact on daily routine, and complications) and leads to improvements across multiple psychosocial domains.
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Affiliation(s)
- Rui Han Liu
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Jenny Yau
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Adeeb Derakhshan
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Roy Xiao
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Tessa A Hadlock
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Linda N Lee
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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4
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Lee LN, McCarty JC, Gadkaree SK, Ford OA, Occhiogrosso J, Yau J, Hadlock TA, Derakhshan A. Effect of Filler Therapy on Psychosocial Distress in Facial Paralysis: Patients with Major Asymmetry Derive Greater Benefit. Facial Plast Surg Aesthet Med 2023; 25:415-419. [PMID: 36459105 DOI: 10.1089/fpsam.2022.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Facial filler is an effective nonsurgical treatment option for improving facial symmetry in patients with facial paralysis (FP). Objective: To compare the effects of filler among patients with FP that is self-perceived as major or minor asymmetry, by measuring psychosocial distress. Methods: In this prospective cohort study of patients with FP undergoing filler at a tertiary academic center, patients were classified as having minor or major self-perceived asymmetry using a visual analog scale (VAS). FACE-Q Appearance-Related Psychosocial Distress was administered before and after filler. Descriptive statistics and a random-effects generalized linear model assessed the relationship between perceived facial asymmetry and change in psychosocial distress. Results: A total of 28 patients participated. Twenty-five (89%) patients were female with median age of 54 (interquartile range [IQR]: 49-66). Median VAS score was 2 (IQR: 1-3.5, 0 = completely asymmetric, 10 = no asymmetry). Psychosocial distress improved in all patients after filler. In multivariable modeling, patients with major asymmetry experienced 2.45 (confidence interval: 0.46-4.44, p = 0.016) points more improvement in psychosocial distress than patients with minor asymmetry. Age, gender, and FP duration were not associated with change in psychosocial distress. Conclusion: Facial filler treatment was seen to improve psychosocial distress in patients with FP, especially by those with more self-perceived deficit.
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Affiliation(s)
- Linda N Lee
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Justin C McCarty
- Division of Plastic Surgery, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shekhar K Gadkaree
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Olivia Abbate Ford
- Division of Plastic Surgery, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jessica Occhiogrosso
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Jenny Yau
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Tessa A Hadlock
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Adeeb Derakhshan
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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Rudy SF, Brenner MJ. Commentary on: "Influence of Subclinical Anxiety and Depression on Quality of Life and Perception of Facial Paralysis" by Rist et al: Is Perception Reality? Facial Plast Surg Aesthet Med 2023; 25:32-34. [PMID: 35984925 DOI: 10.1089/fpsam.2022.0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Shannon F Rudy
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Michael J Brenner
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Ottenhof MJ, Veldhuizen IJ, Hensbergen LJV, Blankensteijn LL, Bramer W, Lei BV, Hoogbergen MM, Hulst RRWJ, Sidey-Gibbons CJ. The Use of the FACE-Q Aesthetic: A Narrative Review. Aesthetic Plast Surg 2022; 46:2769-2780. [PMID: 35764813 PMCID: PMC9729314 DOI: 10.1007/s00266-022-02974-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/25/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In the past decade there has been an increasing interest in the field of patient-reported outcome measures (PROMs) which are now commonly used alongside traditional outcome measures, such as morbidity and mortality. Since the FACE-Q Aesthetic development in 2010, it has been widely used in clinical practice and research, measuring the quality of life and patient satisfaction. It quantifies the impact and change across different aspects of cosmetic facial surgery and minimally invasive treatments. We review how researchers have utilized the FACE-Q Aesthetic module to date, and aim to understand better whether and how it has enhanced our understanding and practice of aesthetic facial procedures. METHODS We performed a systematic search of the literature. Publications that used the FACE-Q Aesthetic module to evaluate patient outcomes were included. Publications about the development of PROMs or modifications of the FACE-Q Aesthetic, translation or validation studies of the FACE-Q Aesthetic scales, papers not published in English, reviews, comments/discussions, or letters to the editor were excluded. RESULTS Our search produced 1189 different articles; 70 remained after applying in- and exclusion criteria. Significant findings and associations were further explored. The need for evidence-based patient-reported outcome caused a growing uptake of the FACE-Q Aesthetic in cosmetic surgery and dermatology an increasing amount of evidence concerning facelift surgery, botulinum toxin, rhinoplasty, soft tissue fillers, scar treatments, and experimental areas. DISCUSSION The FACE-Q Aesthetic has been used to contribute substantial evidence about the outcome from the patient perspective in cosmetic facial surgery and minimally invasive treatments. The FACE-Q Aesthetic holds great potential to improve quality of care and may fundamentally change the way we measure success in plastic surgery and dermatology. LEVEL OF EVIDENCE III 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)
- Maarten J Ottenhof
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands.
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Inge J Veldhuizen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Lusanne J V Hensbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Louise L Blankensteijn
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - Wichor Bramer
- Medical Library, Erasmus MC, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Berend Vd Lei
- Department of Plastic Surgery, University and University Medical School of Groningen and Bey Bergman Clinics, Groningen, The Netherlands
| | - Maarten M Hoogbergen
- Department of Plastic and Reconstructive Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands
| | - René R W J Hulst
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Chris J Sidey-Gibbons
- Patient-Reported Outcomes, Value & Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
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7
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Flynn J, Kaufman-Goldberg T. Functionally Addressing Perioral Impairments of the Paralyzed Face. Facial Plast Surg 2022; 38:405-410. [PMID: 35820445 DOI: 10.1055/s-0042-1750292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Management of facial palsy is targeted toward correction of individual patient concerns. Both esthetic perioral changes to the face and functional perioral deficits are commonly concerning to patients with facial paly. Herein, we review perioral impairments resulting from both flaccid and postparalytic facial palsy. Additionally, we discuss targeted therapy and a multitude of technical interventions aimed at restoring perioral functionality to optimize oral competence, speech articulation, and quality of life for facial palsy patients.
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Affiliation(s)
- John Flynn
- Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Tal Kaufman-Goldberg
- Division of Facial Plastic and Reconstructive Surgery, Massachusetts Eye and Ear, Boston, Massachusetts
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8
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Thielker J, Kouka M, Guntinas-Lichius O. [Preservation, reconstruction, and rehabilitation of the facial nerve]. HNO 2022; 71:232-242. [PMID: 35288765 PMCID: PMC8920054 DOI: 10.1007/s00106-022-01148-y] [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] [Accepted: 12/09/2021] [Indexed: 11/12/2022]
Abstract
Der Umgang mit dem N. facialis ist bei der Operation eines Parotiskarzinoms wichtig für die Langzeitlebensqualität des Patienten. In etwa 2 Drittel der Fälle ist der N. facialis nicht vom Tumor befallen. In diesen Fällen sind neben vollständiger Tumorentfernung die Identifizierung und der Erhalt des Nervs für eine erfolgreiche Operation wesentlich. Ist der Nerv vom Tumor infiltriert, muss der betroffene Teil des Nervs im Rahmen einer radikalen Parotidektomie reseziert werden. Die primäre Nervenrekonstruktion, sofern möglich, führt zu den besten funktionellen und kosmetischen Langzeitergebnissen. Das individuell optimale Therapiekonzept basiert zum einen auf der klinischen Prüfung der Gesichtsbeweglichkeit, zum anderen auf der präoperativen Bildgebung, um die Lagebeziehung zwischen Tumor und Nerv zu verstehen, und schließlich auf einer elektrophysiologischen Untersuchung zur Funktion des Nervs. Intraoperativ hilft ein standardisiertes Vorgehen, um den Nerv zu identifizieren und zu erhalten. Wenn eine radikale Parotidektomie indiziert ist, kann bereits die präoperative Diagnostik helfen, neben der einzeitigen Rekonstruktion auch die adjuvante postoperative Therapie zu planen. Das Ziel der Rehabilitation ist die Wiederherstellung von Tonus, Symmetrie und Bewegung des gelähmten Gesichts. Die Wiederherstellung des Augenschlusses hat hohe Priorität. Bei der chirurgischen Therapie von Gesichtslähmungen gab es in den letzten Jahren viele Verbesserungen. Die vorliegende Arbeit gibt einen Überblick über die jüngsten Fortschritte in der Diagnostik, den Operationstechniken und weiteren Möglichkeiten zur Protektion des gesunden N. facialis. Anderseits wird die Rehabilitation des tumorinfiltrierten N. facialis im Kontext der Behandlung von Speicheldrüsenmalignomen beschrieben.
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Affiliation(s)
- Jovanna Thielker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.,Fazialis-Nerv-Zentrum, Universitätsklinikum Jena, Jena, Deutschland
| | - Mussab Kouka
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.,Fazialis-Nerv-Zentrum, Universitätsklinikum Jena, Jena, Deutschland
| | - Orlando Guntinas-Lichius
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. .,Fazialis-Nerv-Zentrum, Universitätsklinikum Jena, Jena, Deutschland.
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9
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Derakhshan A, Reny DC, Rathi VK, McCarty JC, Lindsay RW, Lee LN, Gadkaree SK. Otolaryngologists Trail Other Specialties in Industry Payments From Dermal Filler Companies. Laryngoscope 2021; 132:301-306. [PMID: 34236083 DOI: 10.1002/lary.29746] [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: 04/21/2021] [Revised: 06/13/2021] [Accepted: 06/29/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS Dermal filler (DF) is a widely used nonsurgical option for facial rejuvenation with a rapidly expanding market. Physician payments by DF industry leaders have yet to be characterized. We sought to investigate trends in physician-industry payments by DF companies over 6 years. Differences in payments based on physician specialty and time were characterized. STUDY DESIGN Database review. METHODS The Open Payments Database was queried from 2013 to 2018. Payments made by the three largest DF companies by market share to otolaryngologists, plastic surgeons, and dermatologists were analyzed. Total dollars paid, number of payments made, type of payments made, and total number of specialists paid were recorded. One-way ANOVA was used for statistical analysis. RESULTS Otolaryngologists, plastic surgeons, and dermatologists received average annual payments of $0.36 million, $6.3 million, and $6.6 million respectively (P < .001). An average of 330 otolaryngologists, 2,128 plastic surgeons, and 5,980 dermatologists were paid annually (P < .001). Accredited speaking arrangements, consulting fees, and royalty/licensing fees comprised the majority of dollars paid to physicians. CONCLUSIONS Average physician payment by DF companies exceeds $12 million annually, with otolaryngologists receiving significantly less compared to plastic surgeons and dermatologists. LEVEL OF EVIDENCE Not applicable Laryngoscope, 2021.
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Affiliation(s)
- Adeeb Derakhshan
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Danielle C Reny
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Vinay K Rathi
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Justin C McCarty
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.,Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Robin W Lindsay
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Linda N Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Shekhar K Gadkaree
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
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10
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Wollina U, Goldman A. Lip enhancement and mouth corner lift with fillers and botulinum toxin A. Dermatol Ther 2020; 33:e14231. [PMID: 32852076 DOI: 10.1111/dth.14231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022]
Abstract
Beautiful lips are responsible for facial attractiveness and a youthful appearance. During aging process, lips become thinner and the red lips borders get poor defined. Downturn of the corners of the mouth suggests negative emotions. Lip surgery and underlying pathology may result in asymmetries and lip incontinence. Minor invasive procedures with hyaluronic acid fillers and botulinum toxin A are versatile tools to improve appearance of the lips, restore function and improve psycho-social well-being. In this review, we discuss anatomy, safety concerns, injections techniques as well as esthetic and medical indications.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
| | - Alberto Goldman
- Department of Plastic Surgery at Hospital São Lucas da PUCS, Porto Alegre, Brazil
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11
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Miller LE, Occhiogrosso J, Lee LN. Cost-Conscious Decision Making: Facial Filler or Surgical Grafting for Facial Paralysis. Facial Plast Surg Aesthet Med 2020; 23:239-240. [PMID: 32614612 DOI: 10.1089/fpsam.2020.0209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lauren E Miller
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Jessica Occhiogrosso
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Linda N Lee
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.,Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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