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Botulinum Toxin: Surely, We Can Do Better? Optimizing Results Beyond On-Label Techniques and Teaching.
Facial expressions and their emotional attributes are essential as an adjunct to verbal communication and for nonverbal communication. Botulinum toxin (BoNTA) used to limit wrinkles induced by aging changes on expressive faces. However, sub…
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Hypersensitivity Reactions Associated With Aesthetic Botulinum Toxin A Injections: A Case Series.
Botulinum toxin type A (BoNT/A) is commonly used in aesthetic treatments for indications such as moderate-to-severe glabellar frown lines. While generally considered safe and effective at low doses, hypersensitivity reactions, though extrem…
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Biostimulating fillers and induction of inflammatory pathways: A preclinical investigation of macrophage response to calcium hydroxylapatite and poly-L lactic acid.
[INTRODUCTION] Initial macrophage response to biostimulatory substances is key in determining the subsequent behavior of fibroblasts and the organization of newly synthesized collagen. Though histological studies suggest that calcium hydrox…
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The Use of Hyaluronidase in Aesthetic Practice: A Comparative Study of Practitioner Usage in Elective and Emergency Situations.
[BACKGROUND] Hyaluronic acids (HAs) continue to be the fillers of choice worldwide and their popularity is growing. Adverse events (AEs) are able to be resolved through the use of hyaluronidase (HYAL). However, routine HYAL use has been at …
- Imitation Is Not Just the Sincerest Form of Flattery-It Is the Sincerest Form of Learning: Reflecting on Rotation Mastopexy.
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Surgical or Nonsurgical Facial Rejuvenation: The Patients' Choice.
[BACKGROUND] Patients seeking a pan-facial rejuvenation may not receive appropriate medical advice on surgical versus nonsurgical treatments, resulting in those who are best-suited for surgery receiving nonsurgical options, and vice versa. …
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Current Practices in Hyaluronic Acid Dermal Filler Treatment in Asia Pacific and Practical Approaches to Achieving Safe and Natural-Looking Results.
Complications such as delayed inflammatory reactions (DIRs) and unnatural outcomes can sometimes arise from hyaluronic acid (HA) dermal filler treatments and can be challenging to address. Given the popularity of HA dermal fillers for aesth…
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Movement of the Syringe During Filler Aspiration: An Ultrasound Study.
[BACKGROUND] Aspiration prior to hyaluronic acid filler injection is often taught as a safety maneuver to minimize the risk of intravascular injection; however, the validity of this technique in aesthetic practice is being increasingly chal…
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Immunogenicity Associated with Aesthetic Botulinumtoxin A: A Survey of Asia-Pacific Physicians' Experiences and Recommendations.
[BACKGROUND] Most botulinum toxin A (BoNT/A) products contain unnecessary bacterial components that increase the risk of developing neutralizing antibodies (nAbs). Reports of secondary nonresponse and treatment failures (STF) due to nAbs ha…
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Creating Lift in the Lower Face With Botulinum Toxin A Treatment: An Anatomical Overview With Videos and Case Studies Illustrating Patient Evaluation and Treatment.
[BACKGROUND] Relaxation of depressor muscles in the lower face with botulinum toxin A (BoNT-A) can create a lifting effect and dramatically improve jawline contour and resting facial expression. Even with the recent increase in interest in …
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Sensory Symptoms Associated with Aesthetic Botulinum Toxin A Treatments.
[UNLABELLED] A retrospective review of patients who switched from onabotulinumtoxinA (onaA) and/or abobotulinumtoxinA (aboA) to incobotulinumtoxinA (incoA) found anecdotal reports of differences in "feel," including a "lighter" feel or trea…
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Pan-Asian Consensus on Calcium Hydroxyapatite for Skin Biostimulation, Contouring, and Combination Treatments.
[BACKGROUND] Several usage guidelines for calcium hydroxylapatite (CaHA), a dermal filler material, exist for non-Asian patients, making it necessary to determine whether their findings and consensuses are applicable to Asian patients who h…
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Neuromodulating the SMAS for Natural Dynamic Results.
Physicians using neuromodulators need to develop an in-depth and holistic understanding of the facial musculature as a single, large, functional structure that does not work in isolation. In this Special Topic, I review the anatomy of the c…
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A Consensus on Minimizing the Risk of Hyaluronic Acid Embolic Visual Loss and Suggestions for Immediate Bedside Management.
[BACKGROUND] Hyaluronic acid fillers have a satisfactory safety profile. However, adverse reactions do occur, and rarely intravascular injection may lead to blindness. Currently there is no internationally recognized consensus on the preven…
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Expert Consensus on the Use of a New Bioengineered, Cell-Friendly, Smooth Surface Breast Implant.
[BACKGROUND] Although general guidelines are available for established silicone gel breast implants, the unique characteristics of the latest Motiva implants warrant specific guidelines. [OBJECTIVES] This study aimed to generate consensus …
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PAN-ASIAN CONSENSUS-Key Recommendations for Adapting the World Congress of Dermatology Consensus on Combination Treatment with Injectable Fillers, Toxins, and Ultrasound Devices in Asian Patients.
The demand for minimally invasive aesthetic procedures has driven requests by physicians for guidance on their use in Asian patients, who have unique cultural preferences, social trends, and anatomy. However, few guidelines exist, particula…
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Influence of patient age on capsular contracture after aesthetic breast augmentation.
The influence of age on capsular contracture rates remains unclear. Most studies have only investigated early capsule development and not whether a link between age at primary surgery and the later development of capsular fibrosis exists. T…
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The superficial venous drainage of the breast: a clinical study and implications for breast reduction surgery.
[BACKGROUND] An understanding of the vascular anatomy of the breast is paramount in breast reduction surgery in order to minimize vascular complications. While most vascular compromise in breast reduction is largely venous in nature, the ve…
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Rotation mastopexy: an anatomical approach.
The goal of a mastopexy is to restore the shape and volume of the breast after ptosis of the breast. Ptosis occurs commonly in response to aging and breastfeeding. A low nipple position on the breast mound can be corrected by addressing the…
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Subglandular breast reduction: the evolution of a minimal scar approach to breast reduction.
The authors describe a new modification of the breast reduction procedure. By means of an inframammary incision, the breast is mobilized from the chest wall, and a "doughnut" annulus of breast tissue is removed from the undersurface of the …