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Choi HS, Wang J, Tauber D, Brown A, Chang K, Liew S, Yi KH. Consensus Recommendations for Treatment of the Upper Face With LetibotulinumtoxinA. PLASTIC AND AESTHETIC NURSING 2024; 44:239-250. [PMID: 39348312 DOI: 10.1097/psn.0000000000000585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
One of the authors (K-H. Y.) convened a panel of seven aesthetic experts from South Korea and Australia to create guidelines for treating facial lines of the upper face with letibotulinumtoxinA. The panel members provided recommendations for injection sites, dosage, and injection techniques for using letibotulinumtoxinA and also considered relevant anatomy, patient assessment and selection, and individual variations to evaluate clinical strategies for minimizing complications. The panelists provided recommendations for treating forehead horizontal lines, glabellar frown lines, and lateral canthal lines. The guidelines developed by the panel will support clinical practitioners of all skill levels in providing safe and effective aesthetic treatments of the forehead, glabellar complex, and lateral canthal lines with letibotulinumtoxinA.
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Affiliation(s)
- Ho-Sung Choi
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Jimmy Wang
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Dahlia Tauber
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Aemillia Brown
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Kathleen Chang
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Steven Liew
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyu-Ho Yi
- Ho-Sung Choi, MD, is a cosmetic surgeon at the PIENA Aesthetic Medical Clinic, Seoul, Korea
- Jimmy Wang, MBBS, is a cosmetic surgeon at Dr Jimmy's Skin and Cosmetics, Mount Gravatt East, Australia
- Dahlia Tauber, MBBS, is an aesthetic physician at Face To Face Medical, Windsor, Australia
- Aemillia Brown, RN, is a nurse injector at Cosmetic Injectables Australia, Brisbane, Australia
- Kathleen Chang, MBBS, is an aesthetic physician at Harmony Cosmetic Injectables, Adelaide, Australia
- Steven Liew, MD, is a plastic surgeon at the Shape Clinic, Darlinghurst, Australia
- Kyu-Ho Yi, MD, PhD, is an anatomist and professor at the Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Korea
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Mora Hurtado AC, Elbuluk N, Taylor SC. Neuromodulators in Skin of Color: An International Review. Dermatol Surg 2024; 50:S73-S79. [PMID: 39196838 DOI: 10.1097/dss.0000000000004313] [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: 08/30/2024]
Abstract
BACKGROUND As the racial/ethnic diversity of the US population grows, it is imperative for dermatologists to recognize the nuances in the aesthetic treatment of diverse populations. OBJECTIVE This comprehensive review explores the safety and efficacy of botulinum toxin A (BTX-A) in skin of color (SOC) populations and highlights variations in aging patterns, skin properties, and aesthetic concerns in SOC populations. MATERIALS AND METHODS A review of PubMed/MEDLINE databases from 2004 to 2024 was performed using combinations of the terms botulinum toxin, SOC, Fitzpatrick, race/ethnicity, and Asian, Latin American, Caribbean, Middle Eastern, African, and Pacific countries. RESULTS Twenty-three articles examining the use of BTX-A in SOC populations were identified. Twelve studies were from East Asia, 5 from the United States and/or Canada, 3 from South Asia/Southeast Asia, 2 from South America, and 1 from the Middle East. Available data suggest that BTX-A is efficacious and well tolerated in SOC populations. CONCLUSION Increased SOC representation in clinical trials may guide the development of tailored treatment approaches to optimize aesthetic outcomes for patients with SOC. A comprehensive knowledge of the variations in aging patterns, skin properties, and aesthetic concerns across SOC populations is essential for providing culturally sensitive cosmetic dermatologic care for diverse populations.
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Affiliation(s)
| | - Nada Elbuluk
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Susan C Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Sirisuthivoranunt S, Wongdama S, Phumariyapong P, Nokdhes YN, Thongjaroensirikul P, Techapichetvanich T, Pettersson M, Ågren M, Wanitphakdeedecha R. Comparative Study on the Duration and Efficacy of Various Botulinum Toxin Type A Injections for Reducing Masseteric Muscle Bite Force and Treating Facial Wrinkles. Dermatol Ther (Heidelb) 2024; 14:1315-1325. [PMID: 38724840 PMCID: PMC11116321 DOI: 10.1007/s13555-024-01177-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/24/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE Botulinum toxin serotype A (BoNT/A) is widely used for minimal invasive aesthetic treatments. Different brands of BoNT/A exhibit structural variations. The aim of this study was to compare the duration and efficacy of various BoNT/A brands available in Thailand for reducing bite force and treating wrinkles. METHODS Fifty participants were randomly assigned to one of five groups, with each group receiving a different BoNT/A brand, namely, incobotulinumtoxinA (IncoA), onabotulinumtoxinA (OnaA), abobotulinumtoxinA (AboA), letibotulinumtoxinA (LetiA), and prabotulinumtoxinA (PraboA). BoNT/A was administered to the masseter muscle and the upper face. Bite force was measured before injection and at 2, 4, 8, 12, 16, 20, and 24 weeks post-injection. Evaluation scores for wrinkle improvement were assessed after the treatment. RESULTS The most significant reduction in bite force occurred between 2 and 4 weeks post-injection. PraboA demonstrated the most substantial reduction in bite force, while IncoA had the least effect. However, the percentage of bite force reduction did not exhibit statistical significance between BoNT/A types. Additionally, the reduction in bite force for all BoNT/A types was reversed at 4 months post-injection. More than half of the participants experienced improvement beyond 16 weeks. CONCLUSIONS The structural differences among BoNT/A brands did not significantly affect the longevity and efficacy of bite force reduction and wrinkle treatment. TRIAL REGISTRATION ClinicalTrials.gov identifier: TCTR20211205001 (registered 4 Dec 2021).
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Affiliation(s)
- Surachet Sirisuthivoranunt
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand
| | - Supisara Wongdama
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand
| | - Phumithep Phumariyapong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand
| | - Ya-Nin Nokdhes
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand
| | - Panwadee Thongjaroensirikul
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand
| | - Thanya Techapichetvanich
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand
| | - Mattias Pettersson
- Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Martin Ågren
- Department of Odontology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkok, 10700, Thailand.
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Rahman E, Philip-Dormston WG, Webb WR, Rao P, Carruthers JD, Carruthers A, Swift A, Goodman GJ, Mosahebi A, Nahai F. Developing Consensus-Based Guidelines for Case Reporting in Aesthetic Medicine: Enhancing Transparency and Standardization. Aesthet Surg J Open Forum 2023; 5:ojad076. [PMID: 37694226 PMCID: PMC10483583 DOI: 10.1093/asjof/ojad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Clinical case reporting plays a vital role in sharing detailed patient narratives, providing insights into rare conditions, innovative treatments, and unexpected outcomes. However, existing reporting guidelines in aesthetic medicine fail to capture the specific nuances of procedures and outcomes in this field. The authors' objectives were to develop comprehensive guidelines for Case REporting in Aesthetic Medicine (CREAM). The study employed a 3-phase consensus process, including a literature review, expert interviews, and a consensus meeting. A diverse group of 10 expert participants (plastic surgeons, dermatologists, noncore specialists, evidence-based medicine expert, and research scientist) in Phase I and 30 experienced aesthetic practitioners in Phase II contributed to the research. Statistical analysis was conducted to assess agreement levels among participants and explore associations and variations within the data. The participants represented various specialties, genders, LGBTQ+ identities, and ethnic backgrounds. The research resulted in the development of the CREAM guidelines, consisting of a 16-item checklist. The guidelines covered essential aspects of case reporting, such as patient and practice information, procedure details, clinical assessment and outcomes, adverse events, and ethical considerations. Statistical analysis indicated a high level of consensus among participants, as well as significant associations between checklist items. CREAM guidelines represent a step toward enhancing transparency and standardization in case reporting in aesthetic medicine. Adhering to these guidelines will allow authors to contribute to a robust evidence base, prioritize patient safety, and drive advancements aesthetic medicine.
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Affiliation(s)
- Eqram Rahman
- Corresponding Author: Dr Eqram Rahman, Pond Street, Hampstead NW3 2QG, UK. E-mail: ; Instagram: @Beyond_border_Aesthetics
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Mueller DS, Prinz V, Adelglass J, Cox SE, Gold MH, Kaufman-Janette J, Nestor MS, Taylor S, Frank K. Efficacy and Safety of Letibotulinumtoxin A in the Treatment of Glabellar Lines: A Randomized, Double-Blind, Multicenter, Placebo-Controlled Phase 3 Study. Aesthet Surg J 2022; 42:677-688. [PMID: 35092418 DOI: 10.1093/asj/sjac019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Letibotulinumtoxin A (Hugel, Inc., Chuncheon, Republic of Korea and CROMA Pharma, Leobendorf, Austria) is a newly manufactured neurotoxin derived from Clostridium botulinum strain CBFC26. OBJECTIVES The aim of this study was to assess the efficacy and safety of letibotulinumtoxin A in reducing glabellar line severity (GLS) and to evaluate long-term safety and efficacy following repeated injections. METHODS In this prospective, randomized, parallel-group, double-blind, multicentre, placebo-controlled Phase III clinical trial, 355 subjects with moderate to severe glabella frown lines received injections of 20 U of letibotulinumtoxin A or placebo. GLS, onset and duration of effect, time to retreatment, and adverse events were evaluated. Response to treatment was defined as a GLS score of 0 or 1 (assessed by the subject and the investigator) and an improvement at Week 4 of ≥2 points in GLS score relative to baseline. RESULTS At 4 weeks, 78.6% of the active treatment subjects were responders based on the investigator's assessment and 68.8% based on the subject's assessment, resulting in a composite responder rate of 64.7% for the active treatment group, whereas the corresponding rate was 0.0% in the placebo group (P < 0.001). Subjects noted a substantial improvement in GL severity as early as Day 2, with the median time to onset of effect being 3 days. The mean [standard deviation] time until first retreatment for the letibotulinumtoxin A group was 127.26 [65.6] days. Letibotulinumtoxin A was well tolerated. CONCLUSIONS Letibotulinumtoxin A demonstrates high efficacy and a convincing safety profile in the treatment of glabellar lines. LEVEL OF EVIDENCE: 2
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Affiliation(s)
| | | | | | | | - Michael H Gold
- Tennessee Clinical Research Center , Nashville, TN , USA
| | | | - Mark S Nestor
- Center for Clinical and Cosmetic Research , Aventura, FL , USA
| | - Susan Taylor
- Perelman Center for Advanced Medicine, University of Pennsylvania , Philadelphia, PA , USA
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