1
|
Nam JH, Choi Y, Lee KJ, Lee JH, Kim KH, Chung CJ. Differences in the 3-dimensional aging changes of the lips among female adults with skeletal Class I, II, and III malocclusion. Am J Orthod Dentofacial Orthop 2023; 164:516-529. [PMID: 37074244 DOI: 10.1016/j.ajodo.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate and compare the 3-dimensional (3D) aging changes of the lips among adult skeletal Class I, II, and III malocclusion. METHODS Female adult orthodontic patients aged 20-50 years with pretreatment cone-beam computed tomography scans were retrospectively classified according to age (20s [20-29 years], 30s [30-39 years], and 40s [40-49 years]) and then subclassified by malocclusion into skeletal Class I, II, and III relationship (9 groups; n = 30 per group). Positional differences in midsagittal and parasagittal soft-tissue landmarks and 3D morphologic aging changes of the lips were evaluated using cone-beam computed tomography scans. RESULTS Labiale superius and cheilion for patients in their 40s indicated a significant downward and backward position compared with those in their 20s, regardless of skeletal classifications (P <0.05). Accordingly, the upper lip height decreased, and the mouth width increased significantly (P <0.05). For Class III malocclusion, the upper lip vermilion angle was greater for patients in their 40s than those in their 20s (P <0.05), whereas the lower lip vermilion angle was only lower for patients with Class II malocclusion (P <0.05). CONCLUSIONS Middle-aged adult females (40-49 years) had a lower upper lip height and greater mouth width than those in their 20s, regardless of skeletal malocclusion. However, prominent morphologic aging changes of the lips were noted on the upper lip for skeletal Class III malocclusion and the lower lip for skeletal Class II malocclusion, implying that the underlying skeletal features (or malocclusion) may influence 3D aging changes of the lips.
Collapse
Affiliation(s)
- Ji-Hye Nam
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Youngjun Choi
- Department of Oral and Maxillofacial Surgery, Dental Center, Chung-Ang University Hospital, Seoul, South Korea
| | - Kee-Joon Lee
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ji-Hyun Lee
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea; Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea; Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chooryung J Chung
- Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea; Department Orthodontics, Gangnam Severance Hospital, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea.
| |
Collapse
|
2
|
Kim JH, Park ES, Nam SM, Choi CY. Comparison of Effectiveness and Safety of a Botulinum Toxin Monotherapy and a Combination Therapy with Hyaluronic Acid Filler for Improving Glabellar Frown. Aesthetic Plast Surg 2022; 46:1872-1880. [PMID: 35552477 DOI: 10.1007/s00266-022-02895-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/27/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Among numerous cosmetic procedures for face rejuvenation performed all over the world, botulinum toxin type A (BoNT-A) for wrinkles is one of the most widely practiced procedures. However, for severe frowns, the application of botulinum toxin is often insufficient. In this study, the effects of hyaluronic acid filler combination therapy and the BoNT-A alone were evaluated. METHODS Forty subjects with 2 or higher points (moderate to severe) of a facial wrinkle scale (FWS) when frowning in the glabellar area were assigned to 2 group: Botulinum toxin type A monotherapy group and a combination regimen of the toxin and hyaluronic acid filler group. Subjects visited outpatient department every 4 weeks until 28 weeks after the injection, and the assessment of the efficacy using FWS, subject satisfaction at both resting and maximum frowning and safety analysis were performed. RESULTS Subjects of both group was administered 18U of BoNT-A and the subjects of the combination group received additional 0.45mL of hyaluronic acid filler regimen. Both at rest and maximum frown, the combination group scored lower FWS than the toxin and showed significance in the week-20 and week-28. And at final visit, subject satisfaction score of the combination was higher than that of toxin group. CONCLUSION For patients with moderate to severe glabellar frown, the combined administration of BoNT-A and hyaluronic acid filler could be a considerable treatment for improving wrinkles. 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 .
Collapse
|
3
|
Swift A, Liew S, Weinkle S, Garcia JK, Silberberg MB. The Facial Aging Process From the "Inside Out". Aesthet Surg J 2021; 41:1107-1119. [PMID: 33325497 PMCID: PMC8438644 DOI: 10.1093/asj/sjaa339] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. With this evidence-based paper, the authors aim to provide a comprehensive overview of the latest research on the etiology and progression of facial aging by explaining the aging process from the “inside out,” that is, from the bony platform to the skin envelope. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. This is followed by an in-depth analysis of specific aging regions by facial thirds (upper, middle, and lower thirds). This review may help aesthetic physicians in the interpretation of the aging process and in prioritizing and rationalizing treatment decisions to establish harmonious facial balance in younger patients or to restore balance lost with age in older patients.
Collapse
Affiliation(s)
- Arthur Swift
- Westmount Institute of Plastic Surgery in Montréal, QC, Canada
| | - Steven Liew
- Shape Clinic in Darlinghurst, NSW, Australia
| | - Susan Weinkle
- Dermatology at the University of South Florida, Tampa, FL, USA
| | - Julie K Garcia
- Health Economics Outcomes Research at Allergan plc, an AbbVie Company, Irvine, CA, USA
| | - Michael B Silberberg
- Allergan Ltd, an AbbVie Company, Parkway, Marlow, Buckinghamshire, United Kingdom
| |
Collapse
|
4
|
Kroumpouzos G, Kassir M, Gupta M, Patil A, Goldust M. Complications of Botulinum toxin A: An update review. J Cosmet Dermatol 2021; 20:1585-1590. [PMID: 33864431 DOI: 10.1111/jocd.14160] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/02/2021] [Accepted: 04/09/2021] [Indexed: 12/01/2022]
Abstract
Cosmetic surgery procedures have increased manifolds all over the world owing to the ever-increasing demand of people to look beautiful and young. Injectable treatments like botulinum toxin are becoming more popular owing to their rapid, well-defined, and lasting results for the reduction of facial fine lines, wrinkles, and facial rejuvenation. These emerging treatments are quite safe but can have certain adverse effects. In this article, we have highlighted the complications and side effects of botulinum toxin based on the anatomical location. The possible causes and precautions to prevent these complications are also discussed. The search of literature included peer-reviewed articles including clinical trials and scientific reviews. Literature was identified from electronic databases (MEDLINE/PubMed) through January 2021 and references of respective articles and only the articles published in English language were included.
Collapse
Affiliation(s)
- George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA.,Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.,GK Dermatology, PC, South Weymouth, MA, USA
| | - Martin Kassir
- Founding Director, Worldwide Laser Institute, Dallas, TX, USA
| | - Mrinal Gupta
- DNB Dermatology Consultant Dermatologist, Treatwell Skin Centre, Jammu, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
5
|
Effective Locations for Injecting Botulinum Toxin into the Mentalis Muscle; Cadaveric and Ultrasonographic Study. Toxins (Basel) 2021; 13:toxins13020096. [PMID: 33514053 PMCID: PMC7911364 DOI: 10.3390/toxins13020096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/28/2022] Open
Abstract
The mentalis muscle is now considered key structures when performing procedures for rejuvenating the lower face. The aim of this study was to determine the anatomical morphology and location of the mentalis muscle and thereby provide anatomical information for facilitating clinical procedures designed to rejuvenate the lower face. Forty-four adult hemifaces from five Thai cadavers and 21 Korean cadavers were dissected to identify the locations of the mentalis muscle. Sixty-six hemifaces from 33 healthy young Korean subjects were included in an ultrasonographic study. The depth of the mentalis muscle below the skin surface, the thickness of the mentalis muscle, and the distance from the bone to the mentalis muscle were measured at the two points that were 5 mm lateral to the most-prominent point of the chin. The mentalis muscle was classified into two types based to its shape: in type A (86.4%, 38 of the 44 cases) it was dome shaped in three dimensions, while in type B (13.6%, 6 of the 44 cases) it was flat. The mentalis muscle was present mostly at the area 5–10 mm from the midsagittal line and 20–30 mm from a horizontal line connecting the mouth corners. The mentalis muscle was present between depths of 6.7 to 10.7 mm below the skin. This new information about the location of the mentalis muscle may help when identifying the most effective and safe botulinum toxin injection points and depths during esthetic procedures for weakened facial rhytides on the lower face.
Collapse
|
6
|
Sinha V, Malik M, Borrelli MR, Sinha A, Cavale N. The quality of online information regarding non-surgical aesthetic procedures. J Plast Reconstr Aesthet Surg 2020; 74:1881-1887. [PMID: 33341383 DOI: 10.1016/j.bjps.2020.12.006] [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: 05/03/2020] [Revised: 08/24/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The rapid growth of non-surgical aesthetics has led to a scarcity of regulation that raises concerns for serious consequences to public health. Services are advertised primarily through websites which are not necessarily centrally monitored or maintained to a set gold standard. We quantitatively assess the quality of online information regarding non-surgical procedures in order to promote patient safety and informed decision making. METHODS Google and Bing, search engines that represent 95.27of global searches, were queried with the expanded search terms "facial filler" and "Botox". The top 100 results were sampled and two validated tools were used to assess the quality of healthcare information retrieved; the DISCERN instrument and the JAMA benchmark criteria. RESULTS Once duplicates were removed, a total of 77 unique websites were retrieved by the search. The majority of websites were published by private marketing firms. The median score for website quality across all included websites was 'fair' (42) when assessed according to the DISCERN instrument, and 'poor' (1) when assessed against the JAMA criteria. Private websites had the lowest quality of information online and institutional websites had the highest. CONCLUSION Non-surgical aesthetics are becoming increasingly popular with patients and clinicians due to their convenience, scope of treatment, and novel and strategic marketing. Online information available to patients, however, is often of poor quality, dominated by private clinics and commercial entities, and thus presents a significant risk of misinforming patients desiring to undertake these procedures. Significant reform and regulation of information is required in order to make this industry safer for patients.
Collapse
Affiliation(s)
- Vikram Sinha
- School of Medical Education, King's College London, London, United Kingdom.
| | - Mohsan Malik
- Department of Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
| | - Mimi R Borrelli
- Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Ambika Sinha
- Barts health NHS Trust, Royal London hospital, London, United Kingdom
| | - Naveen Cavale
- Surgical Department, King's College Hospital, London, United Kingdom
| |
Collapse
|
7
|
de Maio M. Myomodulation with Injectable Fillers: An Innovative Approach to Addressing Facial Muscle Movement. Aesthetic Plast Surg 2020; 44:1300-1316. [PMID: 32844271 DOI: 10.1007/s00266-020-01825-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/04/2018] [Indexed: 11/28/2022]
Abstract
Consideration of facial muscle dynamics is underappreciated among clinicians who provide injectable filler treatment. Injectable fillers are customarily used to fill static wrinkles, folds, and localized areas of volume loss, whereas neuromodulators are used to address excessive muscle movement. However, a more comprehensive understanding of the role of muscle function in facial appearance, taking into account biomechanical concepts such as the balance of activity among synergistic and antagonistic muscle groups, is critical to restoring facial appearance to that of a typical youthful individual with facial esthetic treatments. Failure to fully understand the effects of loss of support (due to aging or congenital structural deficiency) on muscle stability and interaction can result in inadequate or inappropriate treatment, producing an unnatural appearance. This article outlines these concepts to provide an innovative framework for an understanding of the role of muscle movement on facial appearance and presents cases that illustrate how modulation of muscle movement with injectable fillers can address structural deficiencies, rebalance abnormal muscle activity, and restore facial appearance.Level of Evidence V 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 .
Collapse
Affiliation(s)
- Maurício de Maio
- Clinica Dr. Maurício de Maio, Avenida Ibirapuera, 2907 cj 1202, São Paulo, SP, Moema EP: 04029200, Brazil.
| |
Collapse
|
8
|
Yu Y, Sun J, Shen Z, Lin X, Xu J. Auxiliary usage of botulinum toxin A in plastic surgery in China. J Cosmet Dermatol 2020; 19:1021-1028. [PMID: 32052557 DOI: 10.1111/jocd.13306] [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: 07/07/2019] [Revised: 11/10/2019] [Accepted: 01/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Currently, botulinum toxin A (BTA) is mainly used in the treatment of muscle spasms and in cosmetic procedures, and its cosmetic indications are expanding rapidly. There have been sporadic reports focused on the preoperative usage of BTA complementing plastic surgery. We briefly summarize the current experience of BTA complementing plastic surgery in China based on clinical experience. METHODS We reported a brief review of the preoperative use of BTA as an accessory to plastic surgery (blepharoplasty, chin augmentation, mandibular angle ostectomy, rhinoplasty, hyaluronic acid fillers injection for wrinkle reduction) based on previous studies and our experience. RESULTS Preoperative treatment with BTA in plastic surgery helps surgeons operate and results in better cosmetic results. CONCLUSIONS Preoperative BTA treatment can reduce the occurrence of surgical complications as well as improve the surgical results in some plastic surgeries. The procedure is suitable for clinical application and worth promoting.
Collapse
Affiliation(s)
- Yijia Yu
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiaqi Sun
- School of Medicine, Zhejiang University, Hangzhou, China
| | - Zeren Shen
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaohu Lin
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinghong Xu
- Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
9
|
Cohen JL, Swift A, Solish N, Fagien S, Glaser DA. OnabotulinumtoxinA and Hyaluronic Acid in Facial Wrinkles and Folds: A Prospective, Open-Label Comparison. Aesthet Surg J 2019; 39:187-200. [PMID: 29762642 DOI: 10.1093/asj/sjy116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background OnabotulinumtoxinA and hyaluronic acid are effective in improving moderate to severe facial wrinkles and folds, with treatment selection traditionally based upon facial area. Objectives This prospective, multicenter, open-label, crossover study evaluated physician-rated efficacy and patient-rated outcomes following moderate to severe facial wrinkles and folds treatment with onabotulinumtoxinA and hyaluronic acid. Methods 152 subjects (25-65 years) were randomized (1:1) to a treatment-sequence of onabotulinumtoxinA/hyaluronic acid or hyaluronic acid/onabotulinumtoxinA, with initial treatment administered on day 1 and 6 additional visits: week 2 (touch-up); week 4 (crossover); week 6 (touch-up); and weeks 8, 12, and 24 (follow-up). Results Between 92% and 100% of subjects in each treatment-sequence group exhibited at least some improvement from baseline at each study visit in the Physician Aesthetic Improvement Scale and the Objective Observer and Patient Global Assessments of Improvement, with no significant between-sequence differences. Subjects reported looking 3 to 6 years younger at each visit, with significant improvements in glabellar, lateral canthal, and horizontal forehead lines, and nasolabial folds. Treatments were well tolerated. Conclusions OnabotulinumtoxinA and hyaluronic acid provide clinically meaningful improvements as rated by physicians, objective observers, and subjects, with clinical synergy in aesthetic effects and duration of response regardless of treatment administration order in subjects seeking improvement in moderate to severe facial wrinkles and folds. Level of Evidence 2
Collapse
Affiliation(s)
- Joel L Cohen
- Associate Clinical Professor of Dermatology, University of Colorado
- Assistant Clinical Professor of Dermatology, University of California, Irvine, CA
| | | | - Nowell Solish
- Division of Dermatology, University of Toronto, Ontario, Canada
| | | | - Dee Anna Glaser
- Department of Dermatology, St. Louis University, St Louis, MO
| |
Collapse
|
10
|
Shome D, Khare S, Kapoor R. An Algorithm Using Botox Injections for Facial Scar Improvement in Fitzpatrick Type IV-VI Skin. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1888. [PMID: 30324067 PMCID: PMC6181490 DOI: 10.1097/gox.0000000000001888] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 06/13/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Wounds of the face are known to heal poorly with conspicuous scarring. Hence, it is crucial to address the distracting effect of muscle pull on immature collagen, which often leads to worsening of scars. STUDY DESIGN Prospective clinical study. METHODS One hundred patients with a minimum of 6 months follow-up were recruited. All patients with depressed scars underwent surgery for scar revision. Two weeks before surgical intervention, intramuscular Botulinum toxin was injected around the scar, to prevent movement of the facial muscles. From the second week postsurgery, Cicatrix (Formulation containing activated Centella Asiatica & Pinus Sylvestris, Catalysis, Spain) was routinely used, 3 times a day, for 6 months post the scar revision surgery. Six weeks postsurgery, Fractional C02 laser treatment was started and performed every 4 weeks. RESULTS Using the Objective Assessment Score and the Subjective Assessment Score, the mean of the scores were taken. All patients had satisfactory results, as measured by a patient satisfaction survey and objectively by the physician assessment. DISCUSSION Botulinum toxin injected before scar revision surgery resulted in the wound being stabilized, better wound healing, and prevention of wound widening during healing. CONCLUSION In view of the results of this study, it is considered worthwhile to offer patients with facial scars, Botulinum toxin injections before scar revision surgery, followed by Fractional C02 laser, along with the routine use of Cicatrix Cream.
Collapse
Affiliation(s)
- Debraj Shome
- From the Department of Facial Plastic Surgery & Director, The Esthetic Clinics, Mumbai, India
| | - Stuti Khare
- Department of Clinical Dermatology, Cosmetic Dermatology & Dermato-Surgery, The Esthetic Clinics, Mumbai, India
| | - Rinky Kapoor
- Department of Dermatology, Cosmetic Dermatology & Dermato-Surgery & Director, The Esthetic Clinics, Mumbai, India
| |
Collapse
|
11
|
Role of Nonsurgical Chin Augmentation in Full Face Rejuvenation: A Review and Our Experience. Dermatol Surg 2018; 44:985-993. [PMID: 29309340 DOI: 10.1097/dss.0000000000001461] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The chin is a critical component to the perception of facial attractiveness. Dermal fillers offer a nonsurgical, temporary method of correcting mild to moderate chin retrusion and resorption. Thus far, discussion of this procedure has been largely limited to the plastic surgery and otolaryngology literature. OBJECTIVE To review pertinent aspects of anatomy, patient evaluation, injection technique, concomitant therapies, and complications in chin augmentation using injectable fillers. METHODS A brief review of the literature surrounding chin augmentation using injectable fillers, as well as the authors' experience in this area, is provided. RESULTS Chin augmentation using injectable fillers can be performed effectively and safely with adequate background knowledge of the regional anatomy and appropriate patient selection. The authors discuss both injection techniques in the published literature and their own approach. Potential complications and concomitant therapies are also reviewed. CONCLUSION As chin augmentation is increasingly recognized as an essential component to complete facial aesthetic rejuvenation, dermatologic surgeons should be familiar with how to safely and effectively perform augmentation with injectable fillers to achieve an optimal cosmetic outcome.
Collapse
|
12
|
Myomodulation with Injectable Fillers: An Innovative Approach to Addressing Facial Muscle Movement. Aesthetic Plast Surg 2018; 42:798-814. [PMID: 29549406 PMCID: PMC5945756 DOI: 10.1007/s00266-018-1116-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/04/2018] [Indexed: 11/02/2022]
Abstract
Consideration of facial muscle dynamics is underappreciated among clinicians who provide injectable filler treatment. Injectable fillers are customarily used to fill static wrinkles, folds, and localized areas of volume loss, whereas neuromodulators are used to address excessive muscle movement. However, a more comprehensive understanding of the role of muscle function in facial appearance, taking into account biomechanical concepts such as the balance of activity among synergistic and antagonistic muscle groups, is critical to restoring facial appearance to that of a typical youthful individual with facial esthetic treatments. Failure to fully understand the effects of loss of support (due to aging or congenital structural deficiency) on muscle stability and interaction can result in inadequate or inappropriate treatment, producing an unnatural appearance. This article outlines these concepts to provide an innovative framework for an understanding of the role of muscle movement on facial appearance and presents cases that illustrate how modulation of muscle movement with injectable fillers can address structural deficiencies, rebalance abnormal muscle activity, and restore facial appearance. LEVEL OF EVIDENCE V 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 .
Collapse
|
13
|
Weinkle SH, Werschler WP, Teller CF, Sykes JM, Shamban A, Rivkin A, Narurkar VA, Kaminer MS, Dayan S, Cohen JL, Gallagher CJ. Impact of Comprehensive, Minimally Invasive, Multimodal Aesthetic Treatment on Satisfaction With Facial Appearance: The HARMONY Study. Aesthet Surg J 2018; 38:540-556. [PMID: 29244069 DOI: 10.1093/asj/sjx179] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals seeking aesthetic treatment have concerns regarding multiple facial areas. OBJECTIVES Assess the aesthetic impact and satisfaction achieved with a multimodal approach to aesthetic treatment using a combination of minimally invasive treatments. METHODS Prospective, multicenter, rater-blinded, 4-month HARMONY study evaluated patient satisfaction and aesthetic impact of a combination of fillers (VYC-20L, HYC-24L, and HYC-24L+), onabotulinumtoxinA, and bimatoprost. Males and females aged 35 to 65 years received on-label, staged treatment with fillers, as needed per investigator assessment, on day 1, with touch ups allowed on day 14. Bimatoprost was self-administered once daily for 17 weeks. OnabotulinumtoxinA was injected into glabellar lines, crow's feet lines, or both at month 3. Primary effectiveness measure was mean change from baseline on the FACE-Q 10-item Satisfaction with Facial Appearance Overall Scale. RESULTS Of 100 patients treated, 93 underwent at least the 4-month posttreatment assessment and were assessed for efficacy. The FACE-Q Satisfaction with Facial Appearance Overall Scale total score increased from baseline (41.2) to month 4 (72.9; P < 0.00001; effect size, 2.7). Improvement following multimodal treatment was observed on FACE-Q individual items. Self-perceived age decreased from 0.2 years older than actual age at baseline to 4.6 years younger at month 4. Nearly all patients (99%) rated themselves as improved or much improved on the Global Aesthetic Improvement Scale. Investigator assessments also demonstrated improvement. Mild to moderate adverse events occurred in 42 patients. CONCLUSIONS Minimally invasive, multimodal treatment resulted in improvements in FACE-Q scores and perceived age, indicating a high degree of patient satisfaction and a younger facial appearance. LEVEL OF EVIDENCE 4
Collapse
Affiliation(s)
- Susan H Weinkle
- Affiliate Clinical Professor of Dermatology, University of South Florida, Tampa, FL
| | - W Philip Werschler
- Assistant Clinical Professor of Medicine/Dermatology, University of Washington, School of Medicine, Seattle, WA
| | | | - Jonathan M Sykes
- Professor and Director of Facial Plastic and Reconstructive Surgery, UC Davis Medical Group, Sacramento, CA
| | - Ava Shamban
- dermatologist in private practice in Santa Monica, CA
| | - Alexander Rivkin
- Assistant Clinical Professor at the David Geffen/UCLA School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | | | | | - Steven Dayan
- facial plastic surgeon in private practice in Chicago, IL
| | - Joel L Cohen
- Associate Clinical Professor, Department of Dermatology, University of Colorado, Boulder, CO
- Assistant Clinical Professor, Department of Dermatology, University of California, Irvine, Irvine, CA
| | - Conor J Gallagher
- Senior Medical Director of Facial Aesthetics at Allergan plc, Irvine, CA
| |
Collapse
|
14
|
Kim KS, Kim YS, Bao K, Wada H, Choi HS, Hahn SK. Bioimaging of botulinum toxin and hyaluronate hydrogels using zwitterionic near-infrared fluorophores. Biomater Res 2017; 21:15. [PMID: 29046820 PMCID: PMC5633902 DOI: 10.1186/s40824-017-0102-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/11/2017] [Indexed: 11/21/2022] Open
Abstract
Background The injection of botulinum toxin (BTX) to reduce facial wrinkles is one of the most frequently performed plastic surgery procedures. The biocompatible hydrogels are injected with BTX for effective tissue augmentation. However, it is difficult to determine the interval of injection for effective tissue augmentation. Method BTX and hyaluronate (HA) hydrogels were labeled with zwitterionic (ZW) near-infrared (NIR) fluorophores and visualized for 3 weeks after injection to BALB/c nude mice. Results BTX-ZW conjugates and diaminohexane (DAH)-HA-ZW hydrogels were successfully prepared by the conventional EDC/NHS chemistry. Using the NIR fluorescence imaging, we confirmed that approximately 10% of BTX-ZW conjugates and 50% of DAH-HA-ZW hydrogels remained 3 weeks post-injection. Conclusion This bioimaging technique using invisible NIR fluorescence light can be exploited for various biomedical applications.
Collapse
Affiliation(s)
- Ki Su Kim
- PHI BIOMED Co., #613, 12 Gangnam-daero 65-gil, Seocho-gu, Seoul, 06612 South Korea.,Department of Organic Materials Science and Engineering, College of Engineering, Pusan National University, 2 Busandaehak-ro 63 beon-gil, Geumjeong-gu, Busan, 46241 South Korea
| | - Yun Seop Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673 South Korea
| | - Kai Bao
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 149 13th Street, Boston, MA 02129 USA
| | - Hideyuki Wada
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 149 13th Street, Boston, MA 02129 USA
| | - Hak Soo Choi
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 149 13th Street, Boston, MA 02129 USA
| | - Sei Kwang Hahn
- PHI BIOMED Co., #613, 12 Gangnam-daero 65-gil, Seocho-gu, Seoul, 06612 South Korea.,Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673 South Korea
| |
Collapse
|
15
|
de Maio M, Swift A, Signorini M, Fagien S. Facial Assessment and Injection Guide for Botulinum Toxin and Injectable Hyaluronic Acid Fillers. Plast Reconstr Surg 2017; 140:265e-276e. [DOI: 10.1097/prs.0000000000003544] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
16
|
Safety and Long-Term Efficacy of Forehead Contouring With a Polycaprolactone-Based Dermal Filler. Dermatol Surg 2016; 42:1256-1260. [DOI: 10.1097/dss.0000000000000913] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
17
|
Sarhan S, Hamad S, Elmougy S. Human injected by Botox age estimation based on active shape models, speed up robust features, and support vector machine. PATTERN RECOGNITION AND IMAGE ANALYSIS 2016. [DOI: 10.1134/s1054661816030184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
18
|
Combining Microfocused Ultrasound With Botulinum Toxin and Temporary and Semi-Permanent Dermal Fillers. Dermatol Surg 2016; 42 Suppl 2:S168-76. [DOI: 10.1097/dss.0000000000000751] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
|
20
|
Chuang J, Barnes C, Wong BJF. Overview of Facial Plastic Surgery and Current Developments. Surg J (N Y) 2016; 2:e17-e28. [PMID: 28824978 PMCID: PMC5553462 DOI: 10.1055/s-0036-1572360] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/05/2016] [Indexed: 11/01/2022] Open
Abstract
Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques.
Collapse
Affiliation(s)
- Jessica Chuang
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Christian Barnes
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, California
| | - Brian J F Wong
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, California
| |
Collapse
|
21
|
Abstract
The contemporary male look includes sharp contours of the face with strong nose, significant malar-midface structure, and a powerful chin with well-defined jawline. Neurotoxins in the upper facial lines should preserve a lower position of the brows and flatter arch in men. Excessive lifting of the eyebrows and full correction of forehead and periorbital lines are not desirable. The use of dermal fillers is fully accepted into the nasolabial. Male patients with sagginess and hollowness related or not related to acquired lipodystrophies are candidates for cheek correction with volumizers. Female attractiveness lies in the cheekbones, and for men, it lies in the chin. The use of volumizers in the chin is very much appreciated by male patients, especially when it is recessed. A strong and masculine appearance is obtained by creating a square chin. Men present slight thinner lips, especially the upper one. Lip reshape in male patients is very much rejected. It requires expertise both in communication and in technical skills to convince male patients to undergo lip treatments with fillers. The use of injectables in male patients is growing. Neurotoxins in the upper facial lines and the use of dermal fillers in the nasolabial folds are widely accepted. The use of volumizers in the chin is highly appreciated. There is clear need of volumizers in the cheek to correct sagginess and hollowness in men. However, proper communication and technique are required. The same applies for the lips. Cheek and lip reshape is still considered a taboo for most patients and injectors.
Collapse
|
22
|
Pompilus F, Burgess S, Hudgens S, Banderas B, Daniels S. Development and validation of a novel patient‐reported treatment satisfaction measure for hyperfunctional facial lines: facial line satisfaction questionnaire. J Cosmet Dermatol 2015; 14:274-85. [PMID: 26264134 DOI: 10.1111/jocd.12166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2015] [Indexed: 11/30/2022]
|
23
|
Yaworsky A, Daniels S, Tully S, Beddingfield F, Kowalski J, Fitzgerald K, Somogyi C, Burgess SM. The impact of upper facial lines and psychological impact of crow's feet lines: content validation of the Facial Line Outcomes (FLO-11) Questionnaire. J Cosmet Dermatol 2015; 13:297-306. [PMID: 25399622 DOI: 10.1111/jocd.12117] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatments for upper facial lines (UFL), the most visible sign of aging, are of interest to patients and clinicians alike. Patient-reported outcomes (PROs) are valuable in evaluating the impact of such treatments; however, regulatory recommendations have stipulated that the patient perspective be central in developing these assessments. OBJECTIVES (1) To evaluate the content validity of the Facial Lines Outcomes Questionnaire, a PRO instrument developed to assess upper facial line impacts, according to the regulatory guidance of the United States Food and Drug Administration and (2) assess whether it adequately measures the psychological impacts associated with crow's feet lines (CFL) (lateral canthal lines) from the patient perspective. METHODS Two patient groups participated in face-to-face qualitative interviews. One group included patients with UFL (Group 1, n = 25 interviews), and the other included patients specifically with CFL (Group 2, n = 41 interviews). Each interview consisted of a concept elicitation and cognitive debriefing phase. RESULTS Interviews with both groups elicited all key concepts of the instrument, including "bothered by facial lines"; "looking older"; "looking less attractive"; and looking "tired," "stressed," or "angry." Most Group 2 patients (n = 35, 85%) agreed that the instrument adequately assessed the psychological impacts associated with CFL. During cognitive debriefing, the majority of patients in both groups agreed the instrument was understandable, comprehensive, and easy to complete. CONCLUSIONS The Facial Line Outcomes Questionnaire is an appropriate and valid tool to assess the impact of UFL and the psychological impacts associated with CFL.
Collapse
|
24
|
|
25
|
Sparavigna A, Fino P, Tenconi B, Giordan N, Amorosi V, Scuderi N. A new dermal filler made of cross-linked and auto-cross-linked hyaluronic acid in the correction of facial aging defects. J Cosmet Dermatol 2014; 13:307-14. [DOI: 10.1111/jocd.12116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Adele Sparavigna
- Derming; Clinical Research and Bioengineering Institute; Monza, MB Italy
| | - Pasquale Fino
- Department of Plastic; Reconstructive and Aesthetic Surgery, University of Rome 'Sapienza', Policlinico 'Umberto I'; Rome Italy
| | - Beatrice Tenconi
- Derming; Clinical Research and Bioengineering Institute; Monza, MB Italy
| | - Nicola Giordan
- Clinical Research Department; Fidia Farmaceutici, Abano Terme; Padua Italy
| | - Vittoria Amorosi
- Department of Plastic; Reconstructive and Aesthetic Surgery, University of Rome 'Sapienza', Policlinico 'Umberto I'; Rome Italy
| | - Nicolò Scuderi
- Department of Plastic; Reconstructive and Aesthetic Surgery, University of Rome 'Sapienza', Policlinico 'Umberto I'; Rome Italy
| |
Collapse
|
26
|
Hexsel D, Dini TD. Advanced Botulinum Toxin Injections for Dynamic Rhytides: Treating the Upper Face, Lower Face, and Beyond. CURRENT DERMATOLOGY REPORTS 2014. [DOI: 10.1007/s13671-014-0075-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Raspaldo H, Gassia V, Niforos FR, Michaud T. Global, 3-dimensional approach to natural rejuvenation: part 1 - recommendations for volume restoration and the periocular area. J Cosmet Dermatol 2013; 11:279-89. [PMID: 23174051 DOI: 10.1111/jocd.12003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND New techniques and products have lead to a global approach for the treatment of signs of aging. However, there is little published literature on the procedures involved in this approach and currently no validated recommendations exist. OBJECTIVES To provide a detailed, practical guide to midfacial volume restoration and rejuvenation of the periocular area based on expert consensus recommendations. METHODS The expert committee took into account both volumetric and dynamic aspects of treatment, as well as benefits of treatment combinations, for example, combining OnabotulinumtoxinA with hyaluronic acid (HA) fillers and volumizers. An aging severity scale was established for each area, together with recommendations of appropriate products, doses, site, depth, and injection techniques, as well as rules to be respected. RESULTS The expert group concluded that volume restoration of the midface is the first essential step in the global approach because treatment for this area has the most significant positive impact. Firstly, it is important to restore the malar contour, as malar volume anchors the structure of the midface. Secondly, an assessment of the effects of malar enhancement on the appearance of the nasolabial folds and the nasojugal fold (tear trough) should be conducted because these aging signs may be decreased by malar enhancement. Finally, treatment for the nasolabial folds and periorbital area with HA should be performed when needed. CONCLUSIONS Practical guidance is provided for midfacial volume restoration and rejuvenation of the periocular area based on validated expert consensus recommendations. This will help esthetic facial physicians to achieve optimum outcomes.
Collapse
Affiliation(s)
- Hervé Raspaldo
- Private Practice, Facial Plastic Surgery Centre, Cannes, France.
| | | | | | | |
Collapse
|
28
|
Carruthers A, Kane MAC, Flynn TC, Huang P, Kim SD, Solish N, Kaeuper G. The Convergence of Medicine and Neurotoxins: A Focus on Botulinum Toxin Type A and Its Application in Aesthetic Medicine—A Global, Evidence-Based Botulinum Toxin Consensus Education Initiative. Dermatol Surg 2013; 39:493-509. [DOI: 10.1111/dsu.12147] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Ilankovan V. Upper face rejuvenation. Int J Oral Maxillofac Surg 2013; 42:423-31. [PMID: 23290567 DOI: 10.1016/j.ijom.2012.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 10/05/2012] [Accepted: 10/11/2012] [Indexed: 10/27/2022]
Abstract
The area of the upper face occupies about one third of the surface area of the whole face. The anatomical landmarks involve the forehead, brow, glabella and the upper lids. Gravitational and intrinsic changes, as well as familial problems affect the aesthetics of the upper face. The author describes the anatomy and pathophysiology of ageing and the importance of making a correct diagnosis. Surgical and non surgical solutions are discussed. The concept of the beneficial effect of antioxidants such as curcumin is introduced. The efficacy of non ablation laser in dermal rejuvenation is explained. The author aims to impart a thorough understanding of the different surgical and non-surgical options for rejuventating the upper face to achieve an unoperated outcome with a healthy looking forehead.
Collapse
Affiliation(s)
- V Ilankovan
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Foundation Trust, Dorset, UK.
| |
Collapse
|
30
|
Shiba M, Matsuo K, Ban R, Nagai F. Evaluation of muscle hyperactivity of the grimacing muscles by unilateral tight eyelid closure and stapedius muscle tone. J Plast Surg Hand Surg 2012; 46:318-25. [PMID: 22998145 DOI: 10.3109/2000656x.2012.696196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Muscle hyperactivity of grimacing muscles, including the orbicularis oculi and corrugator supercilii muscles that cause crow's feet and a glabellar frown line with ageing, cannot be accurately evaluated by surface observation. In 71 subjects, this study investigated the extent to which grimacing muscles are innervated by the bilateral motor cortices, whether the corticofacial projection to the grimacing muscles affects the facially innervated stapedius muscle tone by measuring static compliance of the tympanic membrane, and whether unilateral tight eyelid closure with contraction of the grimacing muscles changes static compliance. Unilateral tight eyelid closure and its subsequent change in the contralateral vertical medial eyebrow position revealed that motor neurons of the orbicularis oculi and corrugator supercilii muscles were innervated by the bilateral motor cortices with weak-to-strong contralateral dominance. The orbicularis oculi, corrugator supercilii, and stapedius muscles innervated by the bilateral motor cortices had increased muscle hyperactivity, which lowered the vertical medial eyebrow position and decreased the static compliance of the tympanic membrane more than those innervated by the unilateral motor cortex. Unilateral enhanced tight eyelid closure with contraction of the grimacing muscles in certain subjects ipsilaterally decreased the static compliance with increased contraction of the stapedius muscle, which probably occurs to immobilise the tympanic membrane and protect the inner ear from loud sound. Evaluation of unilateral tight eyelid closure and the subsequent change in the contralateral vertical medial eyebrow position as well as a measurement of the static compliance for the stapedius muscle tone has revealed muscle hyperactivity of grimacing muscles.
Collapse
Affiliation(s)
- Masato Shiba
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | | | | | | |
Collapse
|
31
|
[Modern soft tissue augmentation--away from treating the single fold to volume replacement in the whole face]. MMW Fortschr Med 2012; 154:51-2, 54. [PMID: 22997941 DOI: 10.1007/s15006-012-1082-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
32
|
Rendon MI. Long-term aesthetic outcomes with injectable poly-l-lactic acid: observations and practical recommendations based on clinical experience over 5 years. J Cosmet Dermatol 2012; 11:93-100. [DOI: 10.1111/j.1473-2165.2012.00609.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
33
|
Cohen JL, Dayan SH, Cox SE, Yalamanchili R, Tardie G. OnabotulinumtoxinA dose-ranging study for hyperdynamic perioral lines. Dermatol Surg 2012; 38:1497-505. [PMID: 22621180 DOI: 10.1111/j.1524-4725.2012.02456.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Few dosing data on onabotulinumtoxinA to treat hyperdynamic perioral lines (POLs) are available. Studying onabotulinumtoxinA in controlled settings is beneficial to treating a hyperfunctional orbicularis oris. OBJECTIVE To compare the dose-response relationship of two doses of onabotulinumtoxinA in hyperdynamic POLs. METHODS Female subjects (N = 60) received injections of onabotulinumtoxinA at four sites totaling 7.5 U or 12.0 U. Subjects returned at weeks 2, 4, 8, 12, 16, and 20. POL severity and total lip satisfaction (TLS) were assessed at all visits. RESULTS Investigator-assessed POL severity was reduced through week 20 for 12.0 U (p < .01). POL reduction for 7.5 U persisted until week 16 (p < .05). Responder rates did not differ until week 12 (12.0 U, 77%; 7.5 U, 36%; p = .003). Subject-assessed TLS was improved (p < .05) at all time points for both groups except at week 20 (12.0 U; p = .06). Most adverse events (AEs) were mild to moderate in severity and typical for onabotulinumtoxinA treatment in the lips, and the incidence was dose-dependent. CONCLUSION OnabotulinumtoxinA provides significant reductions in POL severity and high levels of subject satisfaction. Lack of dose response and fewer AEs suggest that treatment of hyperdynamic POLs with 7.5 U appears adequate for up to 16 weeks.
Collapse
Affiliation(s)
- Joel L Cohen
- AboutSkin Dermatology and DermSurgery, Englewood, CO 80113, USA.
| | | | | | | | | |
Collapse
|
34
|
Abstract
Since its initial approval by the US Food and Drug Administration (FDA) 20 years ago for the treatment of strabismus, hemifacial spasm, and blepharospasm in adults, botulinum toxin (BTX) has become one of the most frequently requested products in cosmetic rejuvenation around the world. After years of clinical success and consistent safety in the upper face, the use of BTX has expanded and evolved to include increasingly complicated indications. In the hands of adept injectors, the focus has shifted from the treatment of individual dynamic rhytides to shaping, contouring, and sculpting, alone or in combination with other cosmetic procedures, to enhance the aesthetic appearance of the face. Although recent reports have questioned the safety of BTX, 25 years of therapeutic and over 20 years of cosmetic use has demonstrated an impressive record of safety and efficacy when used appropriately by experienced injectors.
Collapse
|
35
|
Goodman GJ. The use of botulinum toxin as primary or adjunctive treatment for post acne and traumatic scarring. J Cutan Aesthet Surg 2010; 3:90-2. [PMID: 21031067 PMCID: PMC2956964 DOI: 10.4103/0974-2077.69019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Botulinum toxin has been utilised successfully in many facial and extra facial regions to limit superfluous movement. Scars, whether traumatic or disease-related, are treated with many modalities. OBJECTIVE To assess the available literature concerning the prophylactic use of botulinum toxin for the improvement in the cosmetic outcome of scars induced by surgery and to examine its role in the treatment of established scars alone, as also combined with other modalities. MATERIAL AND METHODS The results of the prophylactic use of botulinum toxin to limit the resultant scarring from surgery are examined by a literature review. The primary and adjunctive use of botulinum toxin in the treatment of post acne and post surgical and traumatic scars is explored by case examples. RESULTS Literature review and personal experience shows good Improvement in the appearance of scars with the use of botulinum toxin alone or with other adjuvant modalities in the treatment of scars. CONCLUSION Botulinum toxin would appear to be useful both in the prophylaxis and treatment of certain types of scars.
Collapse
|
36
|
|
37
|
Abstract
PURPOSE OF REVIEW The art and science of facial rejuvenation is an ever-evolving field of medicine, as evidenced by the continual development of new surgical and nonsurgical treatment modalities. Over the past 10 years, the use of botulinum toxin and dermal fillers for aesthetic purposes has risen sharply. Herein, we discuss properties of several commonly used injectable products and provide basic instruction for their use toward the goal of achieving facial rejuvenation. RECENT FINDINGS The demand for nonsurgical injection-based facial rejuvenation products has risen enormously in recent years. Used independently or concurrently, botulinum toxin and dermal filler agents offer an affordable, minimally invasive approach to facial rejuvenation. SUMMARY Botulinum toxin and dermal fillers can be used to diminish facial rhytides, restore facial volume, and sculpt facial contours, thereby achieving an aesthetically pleasing, youthful facial appearance.
Collapse
|
38
|
Ghalamkarpour F, Robati RM, Aryanejad F, Toossi P. Supraciliary wrinkles and botulinum toxin A. Clin Exp Dermatol 2010; 35:388-91. [DOI: 10.1111/j.1365-2230.2009.03607.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
39
|
|
40
|
Niforos RF. [Midfacial nonsurgical rejuvenation]. ANN CHIR PLAST ESTH 2009; 54:444-53. [PMID: 19716218 DOI: 10.1016/j.anplas.2009.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Accepted: 05/17/2009] [Indexed: 10/20/2022]
Abstract
Better new understanding of midfacial ageing and new techniques such as botulinum toxin and hyaluronic acid injections have widely changed the approach of the treatment. After reviewing the different available products, the author preconizes for each an overview with indications, limits and possible complications. The author highlights the benefit of these techniques for lower lid and tear trough treatments. Besides, the author suggests associating these techniques for natural and long lasting results.
Collapse
Affiliation(s)
- R-F Niforos
- Clinique Niforos, 55, boulevard des Belges, 69006 Lyon, France.
| |
Collapse
|
41
|
Abstract
Upper eye lid blepharoplasty is one of the most commonly practiced surgical treatments in aesthetic medicine. Careful patient selection, thorough preoperative planing, and exact surgical treatment lead to optimal results. CO(2) laser assisted surgery provides a dry and clear surgical field, allowing precise tissue control. On the other hand CO(2) laser subsurfacing leads due to thermal effect to a shrinking of the lax orbital septum, and reduces the need for orbital fat resection or even allows one to avoid fat resection. Periorbital combination treatments in most cases allow smaller or less invasive procedures, reducing risk factors. Additionally they adapt to individual anatomic structures, different needs in outcome and show synergistic effects. Aesthetic dermatology incorporates many conservative and invasive approaches, so that upper eyelid blepharoplasty in dermatologic surgery is widely accepted and well-established.
Collapse
Affiliation(s)
- W Prager
- Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg.
| | | |
Collapse
|
42
|
Abstract
BACKGROUND A new dermal filler has been developed with preincorporated lidocaine for the treatment of moderate/severe wrinkles. AIMS Injector and patient evaluation of comfort and aesthetic results obtained with a new hyaluronic acid filler incorporating lidocaine (HAL) following treatment of nasolabial folds. PATIENTS/METHODS Three thousand five hundred and sixty-six patients were recruited by 485 injectors across 16 countries. All patients had previously received facial fillers but now required further treatment. All patients received the new hyaluronic acid filler incorporating lidocaine. RESULTS Injector assessment of HAL was that it was very easy to inject in > 75% of patients, and postinjection sculpting/massaging was very easy in most patients (> 70%). Both injectors and patients reported low patient pain levels, with patients experiencing less pain during all stages of the HAL injection procedure compared to previous dermal fillers. Over 95% of injectors rated the aesthetic effect of HAL as "excellent" or "good," with 99.1% stating they would recommend treatment to a colleague and 99.4% recommending treatment to other patients. More than 90% of patients were happy with the treatment, and 99% would recommend HAL to friends. CONCLUSIONS The new hyaluronic acid filler incorporating lidocaine provides a more comfortable injection experience and improved aesthetic result for most patients compared with other dermal fillers used previously.
Collapse
|
43
|
Cosmetic Wrinkle Reduction with Botulinum Toxin. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
44
|
Brandt FS, Cazzaniga A. Hyaluronic acid gel fillers in the management of facial aging. Clin Interv Aging 2008; 3:153-9. [PMID: 18488885 PMCID: PMC2544360 DOI: 10.2147/cia.s2135] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Time affects facial aging by producing cellular and anatomical changes resulting in the consequential loss of soft tissue volume. With the advent of new technologies, the physician has the opportunity of addressing these changes with the utilization of dermal fillers. Hyaluronic acid (HA) dermal fillers are the most popular, non-permanent injectable materials available to physicians today for the correction of soft tissue defects of the face. This material provides an effective, non invasive, non surgical alternative for correction of the contour defects of the face due to its enormous ability to bind water and easiness of implantation. HA dermal fillers are safe and effective. The baby-boomer generation, and their desire of turning back the clock while enjoying an active lifestyle, has expanded the popularity of these fillers. In the US, there are currently eight HA dermal fillers approved for commercialization by the Food and Drug Administration (FDA). This article reviews the innate properties of FDA-approved HA fillers and provides an insight on future HA products and their utilization for the management of the aging face.
Collapse
|
45
|
Advances in Facial Rejuvenation: Botulinum Toxin Type A, Hyaluronic Acid Dermal Fillers, and Combination Therapies???-Consensus Recommendations. Plast Reconstr Surg 2008; 121:5S-30S. [DOI: 10.1097/prs.0b013e31816de8d0] [Citation(s) in RCA: 260] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
46
|
|
47
|
Abstract
The male cosmetic population has been more timid over the years for procedures for facial rejuvenation. Only with the advent of minimally invasive procedures such as Botox and fillers have men begun to participate in cosmetic treatments. Men come with esthetic needs and areas of treatment different from women and require a different array of injectable fillers for each of these problems. Wrinkle ablation, volumization, and sculpting facial contours are procedures with the various agents available.
Collapse
Affiliation(s)
- Gary D Monheit
- Total Skin and Beauty Dermatology Center and Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
| | | |
Collapse
|
48
|
Dermal Fillers. Obstet Gynecol 2007. [DOI: 10.1097/01.aog.0000285532.73312.f9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
49
|
Abstract
PURPOSE : To describe and evaluate a technique for minimization of lateral periocular rhytids ("crow's feet") with the wire scalpel surgical instrument. METHODS : Six patients with significant crow's feet were prospectively selected for treatment with the wire scalpel. Preoperative and postoperative photographs were evaluated for severity of crow's feet. RESULTS : Significant improvement in the appearance of crow's feet was noted in 5 of the 6 patients. CONCLUSIONS : The wire scalpel surgical instrument can reduce the severity of lateral periocular rhytids via minimally invasive subcutaneous dissection.
Collapse
|