Assuntos
Rejuvenescimento , Envelhecimento da Pele/fisiologia , Publicidade , Idoso , Antioxidantes/administração & dosagem , Senescência Celular/fisiologia , Senescência Celular/efeitos da radiação , Técnicas Cosméticas , Cosméticos , Fármacos Dermatológicos/administração & dosagem , Feminino , Terapia de Reposição Hormonal , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/prevenção & controle , Pele/efeitos dos fármacos , Pele/fisiopatologia , Absorção Cutânea/fisiologia , Absorção Cutânea/efeitos da radiação , Envelhecimento da Pele/efeitos da radiação , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/prevenção & controle , Análise Espectral Raman , Protetores Solares/administração & dosagem , Resultado do Tratamento , Raios Ultravioleta/efeitos adversosRESUMO
BACKGROUND: Botulinum toxin type A remains the most popular nonsurgical aesthetic treatment worldwide. Previous consensus statements have focused on Caucasians and on Koreans as generally representative of Asians. However, indications and dosages vary among different ethnic groups. This publication reports the results of a multidisciplinary, pan-Asian consensus focusing on incobotulinumtoxinA. METHODS: A consensus group of plastic surgeons and dermatologists from Asia, Europe, and the United States convened for a live meeting in Asia, followed by a questionnaire-based Delphi procedure. Treatment of Asians in both their native countries and countries of migration was discussed. RESULTS: For most items, the group achieved a majority consensus. A number of treatment indications, strategies, and dosages were identified in Asians, which are distinct to those previously described for Caucasians due to differences in facial morphotypes, anatomy, and cultural expectations. The group also formulated position statements for intradermal botulinum toxin type A ("mesotoxin"), body shaping with the calves as a paradigm, and reduction of parotid glands. While Asians have previously been considered a homogeneous group for the purposes of aesthetic treatment, this publication considers regional variations. A new classification of Asian facial morphotypes is proposed to aid treatment planning and implementation. CONCLUSIONS: This is the first pan-Asian consensus for aesthetic use of botulinum toxin type A. Its unique objective is to optimize treatment safety and efficacy for patients of complete or part-Asian ancestry in all regions. The recommendations for incobotulinumtoxinA may be extended with care to other botulinum toxin formulations.