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Poulain B.,University of Strasbourg | Trevidic P.,Rue de Sontay | Clave M.,Avenue de Flirey | Aharoni C.,Clinique Esthetique de Paris Spontini | And 16 more authors.
Journal of Drugs in Dermatology | Year: 2013

Botulinum neurotoxins are the most popular non-surgical treatments for aesthetic indications, but there is uncertainty about whether certain formulations are comparable in efficacy and safety and can be substituted for one another by a simple one to one dose conversion ratio. An expert panel of French practitioners was convened to establish a consensus on the clinical equivalence in efficacy and safety of OnabotulinumtoxinA (900 KDa) and IncobotulinumtoxinA (neurotoxin free from complexing proteins - 150 KDa). The consensus was divided into three sections incorporating a biological, bibliographic and clinical analysis of the two toxins. This included a review of the published data that have directly compared the two toxins for aesthetic indications and a survey of the panel's extensive clinical experience with the two toxins in terms of efficacy and safety. All panel members reviewed and endorsed the content of each section. Among this expert panel of French aesthetic physicians and biologists there was consensus that OnabotulinumtoxinA and IncobotulinumtoxinA are clinically equivalent in terms of efficacy and safety, and that a switch from one drug to the other can be made using a simple 1:1 conversion ratio. Copyright © 2013 Journal of Drugs in Dermatology.


Dallara J.-M.,Center Laser Dermatologique Laser | Baspeyras M.,Center Bordelais Dermatologie Esthetique | Bui P.,Rue du Champ de Mars | Cartier H.,Square Saint Jean | And 2 more authors.
Journal of Cosmetic Dermatology | Year: 2014

Background: Age-associated volume loss is now known to play an important role in the structural changes of the aging face. In the lower face, this manifests as drooping of the corners of the mouth and jowl leading to a loss of the oval jawline of youth. Jawline reshaping by replacing volume has therefore become an indispensable component of modern facial rejuvenation. Aim: Calcium hydroxylapatite (CaHA; Radiesse®, Merz Pharmaceuticals GmbH, Frankfurt, Germany) is an injectable filler with a cosmetic indication for tissue augmentation. The ability of calcium hydroxylapatite to provide immediate and long-lasting volume enhancement makes it an ideal agent for restoring an oval jawline. Method: This consensus statement has been developed to assist clinicians who would like to gain more experience in the use of volumizing agents to achieve an optimal outcome with this procedure. Results: Using the recently developed Merz Aesthetics Scale® for jawline, the consensus provides a treatment protocol for individuals at each stage of oval loss and presents a series of before and after images to illustrate the improvements that can be achieved. Specific recommendations for calcium hydroxylapatite including type of anesthesia, injection techniques, volume for injection, use in combination with other procedures, and expected duration of corrections are provided. Techniques for minimizing and managing expected problems and potential complications are also described. Conclusion: Calcium hydroxylapatite is appropriate for treating patients at any stage of oval loss. © 2014 Wiley Periodicals, Inc.


Dallara J.-M.,Center Laser Dermatologique Laser
Aesthetic Plastic Surgery | Year: 2012

Background Hand rejuvenation aims to restore volume and produce smooth, elastic skin. A combined treatment has been proposed: Juvéderm Ultra® 3 for filling and smoothing the skin and Juvéderm® Hydrate to rehydrate and restore skin quality. Methods Twenty physicians enrolled 99 subjects (i.e., 198 hands). At the first visit, hands were injected with Juvéderm Ultra® 3. At the second visit (day 15) hands were treated with Juvéderm® Hydrate. A final assessment was made at day 30. Results Ninety-eight percent of subjects were female (mean age = 60.3 years). Mean volumes injected were 1.02 ml Juvéderm Ultra® 3 per hand at day 0 and 0.91 ml Juvéderm® Hydrate per hand at day 15. Mean grading on the Hand Aging Scale was 3.18 preinjection, which decreased to 1.73 on study completion (p < 0.0001). Injections were rated as "very easy/easy" in 99.4 and 98.9 % of cases for Juvéderm Ultra® 3 and Juvéderm® Hydrate, respectively. Most physicians found both products "very easy/easy" to massage. Physician evaluation based on the Global Aesthetic Improvement Scale (GAIS) showed that the proportion of "very much/much improved" was significantly higher at days 15 and 30 compared to baseline (63.7 and 70.3 vs. 41.8 %). Patient GAIS scores showed that the proportion of "much improved" was significantly higher at day 30 than at day 15 (53.1 vs. 43.9 %). Over 94 % of physicians and approximately 90 % of subjects would recommend treatment. The adverse event rate was 8.2 %, including edema, hematoma, redness, and pain. Conclusion Combined Juvéderm Ultra® 3 and Juvéderm® Hydrate treatment is effective and safe for rejuvenating the aging hand. 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 at www.springer.com/00266. © Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2012.


PubMed | Center Laser Dermatologique Laser
Type: Journal Article | Journal: Aesthetic plastic surgery | Year: 2012

Hand rejuvenation aims to restore volume and produce smooth, elastic skin. A combined treatment has been proposed: Juvderm Ultra 3 for filling and smoothing the skin and Juvderm Hydrate to rehydrate and restore skin quality.Twenty physicians enrolled 99 subjects (i.e., 198 hands). At the first visit, hands were injected with Juvderm Ultra 3. At the second visit (day 15) hands were treated with Juvderm Hydrate. A final assessment was made at day 30.Ninety-eight percent of subjects were female (mean age=60.3 years). Mean volumes injected were 1.02 ml Juvderm Ultra 3 per hand at day 0 and 0.91 ml Juvderm Hydrate per hand at day 15. Mean grading on the Hand Aging Scale was 3.18 preinjection, which decreased to 1.73 on study completion (p<0.0001). Injections were rated as very easy/easy in 99.4 and 98.9% of cases for Juvderm Ultra 3 and Juvderm Hydrate, respectively. Most physicians found both products very easy/easy to massage. Physician evaluation based on the Global Aesthetic Improvement Scale (GAIS) showed that the proportion of very much/much improved was significantly higher at days 15 and 30 compared to baseline (63.7 and 70.3 vs. 41.8%). Patient GAIS scores showed that the proportion of much improved was significantly higher at day 30 than at day 15 (53.1 vs. 43.9%). Over 94% of physicians and approximately 90% of subjects would recommend treatment. The adverse event rate was 8.2 %, including edema, hematoma, redness, and pain.Combined Juvderm Ultra 3 and Juvderm Hydrate treatment is effective and safe for rejuvenating the aging hand.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 at www.springer.com/00266.

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