Two multinational, observational surveys investigating perceptions of beauty and attitudes and experiences relating to aesthetic medical procedures.

BACKGROUND: Data on opinions and experiences of aesthetic medical procedures outside the United States and Western Europe are scarce. AIMS: This study aimed to survey users and non-users of aesthetic procedures in countries where this information is less readily available, to understand attitudes and perceptions relating to beauty. PATIENTS/METHODS: Two independent internet-based observational surveys were conducted. Survey 1: individuals from Colombia, Lebanon, Malaysia, Russia and Turkey who were 'users' or 'non-users' of aesthetic medical procedures. Survey 2: individuals from Colombia, Russia, Thailand, Turkey and the United Arab Emirates who were 'users' of non-surgical aesthetic treatments. RESULTS: Surveys 1 and 2 were completed by 300 and 160 individuals, respectively, most of whom were female (94.0% and 99%). Overall, respondents rated the eyes and smile as the most pleasing male and female facial features. Most participants (mean 82.6%; range 75%-100%) believed maintaining a healthy lifestyle was important for ageing gracefully, and over one-third (36.0%; 28%-47%) believed men age more gracefully than women. The emphasis respondents placed on the importance of physical attributes vs inner feelings, internal beauty and self-confidence varied between countries. Users were often more positive about aesthetic medical procedure outcomes than non-users. Adequate information, good physician communication (including managing treatment expectations), treatment recommendations based on patient need and good aftercare improved treatment satisfaction. CONCLUSIONS: The eyes and smile were key features of attractiveness, but maintaining a healthy lifestyle was consistently considered an important factor for ageing gracefully. Ensuring patients are well informed was a major determinant of treatment satisfaction.

IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations.

BACKGROUND: Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A) in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy and tolerability data for incobotulinumtoxinA in various facial aesthetic indications and to give expert consensus recommendations to ensure best clinical practice among Russian clinicians. METHODS: Thirteen dermatology and/or plastic surgery experts attended meetings held in Paris, France (November 2013), and Moscow, Russia (March 2014). The expert group reviewed and analyzed the existing evidence, consensus recommendations, and Russian experts' extensive practical experience of incobotulinumtoxinA in aesthetics to reach consensus on optimal doses, potential dose adjustments, and injection sites of incobotulinumtoxinA for facial aesthetics. RESULTS: All experts developed guidance on the optimal doses for incobotulinumtoxinA treatment of different regions of the upper and lower face. The expert panel agreed that there are no differences in the efficacy and duration of the effect between the four BoNT/As that are commercially available for facial aesthetic indications in Russia and that, when administered correctly, all BoNT/As can achieve optimal results. Experts also agreed that nonresponse to BoNT/A can be caused by neutralizing antibodies. CONCLUSION: On the basis of the scientific and clinical evidence available for incobotulinumtoxinA, coupled with the extensive clinical experience of the consensus group, experts recommended the optimal doses of incobotulinumtoxinA effective for treatment of wrinkles of the upper and lower face to achieve the expected aesthetic outcome. These first Russian guidelines on the optimal use of incobotulinumtoxinA for augmentation of glabellar lines, periorbital wrinkles, forehead lines, bunny lines, perioral wrinkles, depressor anguli oris, mentalis, masseters and platysmal bands, and performing the Nefertiti lift, are presented here.

De novo COX2 mutation in a LHON family of Caucasian origin: implication for the role of mtDNA polymorphism in human pathology.

Recent studies suggest that certain mutations with phylogeographic importance as haplogroup markers may also influence the phenotypic expression of particular mitochondrial disorders. One such disorder, Leber's hereditary optic neuropathy (LHON), demonstrates a clear expression bias in mtDNAs belonging to haplogroup J, a West Eurasian maternal lineage defined by polymorphic markers that have been called 'secondary' disease mutations. In this report, we present evidence for a de novo heteroplasmic COX2 mutation associated with a LHON clinical phenotype. This particular mutation-at nucleotide position 7,598-occurs in West Eurasian haplogroup H, the most common maternal lineage among individuals of European descent, whereas previous studies have detected this mutation only in East Eurasian haplogroup E. A review of the available mtDNA sequence data indicates that the COX2 7598 mutation occurs as a homoplasic event at the tips of these phylogenetic branches, suggesting that it could be a variant that is rapidly eliminated by selection. This finding points to the potential background influence of polymorphisms on the expression of mild deleterious mutations such as LHON mtDNA defects and further highlights the difficulties in distinguishing deleterious mtDNA changes from neutral polymorphisms and their significance in the development of mitochondriopathies.