Subject(s)
Melanosis/drug therapy , Sunburn/prevention & control , Sunscreening Agents/administration & dosage , Drug Approval , Drug Labeling/standards , Humans , Melanosis/immunology , Melanosis/pathology , Propiophenones/administration & dosage , Propiophenones/chemistry , Propiophenones/standards , Skin/drug effects , Skin/immunology , Skin/pathology , Skin/radiation effects , Skin Pigmentation/drug effects , Skin Pigmentation/radiation effects , Sun Protection Factor/standards , Sunburn/etiology , Sunburn/pathology , Sunlight/adverse effects , Sunscreening Agents/chemistry , Sunscreening Agents/standards , Ultraviolet Rays/adverse effects , United States , United States Food and Drug Administration/standardsABSTRACT
There are a multitude of uses for BoNT in the aesthetic realm. Efficacy has been shown in softening glabellar creases, crows feet, forehead rhytides, and in correcting facial asymmetries, including mild eyelid ptosis. Facial shape can be altered through injections of BoNT into masseter, and smiles can be altered with BoNT. Clinical examples of the above will be shown, as well as adverse outcomes with inaccurate injection techniques.
Subject(s)
Botulinum Toxins/therapeutic use , Cosmetic Techniques , Blepharoptosis/drug therapy , Esthetics , Face , Facial Asymmetry/drug therapy , Humans , Skin Aging/drug effectsABSTRACT
BACKGROUND: Various scoring techniques prone to subjective interpretation have been used to evaluate soft tissue augmentation of nasolabial folds (NLFs). OBJECTIVE: To design and validate a reliable wrinkle assessment scoring scale. MATERIALS AND METHODS: Six photographed wrinkles of varying severity were electronically copied onto the same facial image to become a 6-point grading scale (GGS). A pilot training program (13 investigators) determined reliability, and a 12-week multicenter survey study validated the GGS scoring method. RESULTS: Pilot study inter- and intrarater scoring reliability were high (weighted kappa scores of 0.85 and 0.86, respectively). Seventy-five percent of survey investigators and independent review panel (IRP) members considered a GGS score difference of 0.5 to be a minimally perceivable difference. Interrater weighted kappa scores were 0.91 for the IRP and 0.80 for investigators. Intrarater agreements after repeat testing were 0.91 and 0.89, respectively. The baseline "live" assessment GGS mean score was 3.34, and the baseline blinded photographic assessment GGS mean score was 2.00 for the IRP and 2.16 for the investigators. CONCLUSIONS: The GGS is a reproducible method of grading the severity of NLF wrinkles. Treatment effectiveness of a dermal filler can be reliably evaluated using the GGS by comparing "live" assessments with the standard GGS photographic panel.
Subject(s)
Collagen/administration & dosage , Prostheses and Implants , Rhytidoplasty/classification , Skin Aging , Surgery, Plastic/education , Adult , Face , Humans , Middle Aged , Observer Variation , Pilot Projects , Reproducibility of Results , Rhytidoplasty/education , Rhytidoplasty/methods , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Periorbital hyperpigmentation is a generally benign, extremely common condition that is notoriously resistant to treatment. According to the author, the key to successful treatment is determining the primary cause and complying with maintenance and preventive regimens. A multimodal approach may be required, encompassing topical bleaching agents, chemical peels, laser therapy, and/or surgery.
