Aesthetic Medicine Nurses and Qualified Nonmedical Practitioners: Our Role and Requirements as Aesthetic Medicine Adapts to Worldwide Changes and Needs.

Aesthetic medicine nursing is a highly skilled specialty, which continues to evolve. A survey of 197 experienced aesthetic medicine nurses practicing in eight countries revealed shortcomings in the current approach to their education, training, and registration. Education and training are currently self-identified and self-funded and are often provided by the companies that manufacture or distribute the products used in aesthetic medicine treatments. Accreditation and registration schemes are not mandatory, and an international professional governing body is lacking to facilitate international cooperation and sharing of best practice. There is a need for an academic, coherent, and comprehensive approach to the training and education of aesthetic medicine nurses that will equip them with the knowledge and experience to not only administer treatments and attain natural looking results but also prevent, recognize, and manage any potential complications associated with such treatments.

Ready-to-use abobotulinumtoxinA solution versus powder botulinumtoxinA for treatment of glabellar lines: Investigators' and subjects' experience in a Phase IV study.

BACKGROUND: Botulinum neurotoxin type A (BoNT-A) is well-established for treatment of glabellar lines (GLs), and mostly formulated as powders requiring reconstitution for injection. The approved liquid formulation, ready-to-use (RTU) abobotulinumtoxinA was developed to ease injection procedures and prevent reconstitution errors. This multicenter, open-label, Phase IV study evaluated GL treatment experience using RTU abobotulinumtoxinA versus powder BoNT-A (onabotulinumtoxinA). METHODS: Females with experience of BoNT-A facial treatment were randomized 2:1 to GL treatment with 50 U RTU abobotulinumtoxinA (N = 99) or 20 U powder BoNT-A (N = 51) and followed-up for 6 months or 1 month, respectively. Assessments included: time to prepare each product for injection (primary endpoint); investigators' experience with product preparation/reconstitution; investigators' and subjects' treatment experience; safety; and for the RTU product: aesthetic improvement of GLs; subject satisfaction. RESULTS: Compared with powder BoNT-A, RTU abobotulinumtoxinA required statistically significantly less preparation time (mean 0:33 vs. 1:34 min: s; p < 0.0001). Investigators preferred RTU abobotulinumtoxinA over powder BoNT-A (81% of treatment sessions) and found it allowed more time to communicate with subjects (97%). All investigators (100%) also found it easy-to-use, easy-to-learn, and that it fulfilled their expectations. Subjects found the RTU abobotulinumtoxinA treatment comfortable (91%), and through 6 months posttreatment, most reported satisfaction with their appearance (≥88%), looking natural (≥95%) and refreshed (≥80%). At Month 1, 99% of RTU-treated subjects had investigator-assessed improved aesthetic appearance in GLs, maintained in 76% at Month 6. No serious adverse events occurred. CONCLUSION: RTU abobotulinumtoxinA for GL treatment is well-tolerated, efficacious, shows high levels of subject satisfaction throughout 6 months, saves time, and is preferred by clinicians over powder BoNT-A. GOV REGISTRY: NCT05277337.

Individualized Treatment Algorithm Using Hyaluronic Acid Fillers for Lifting, Contouring and Volumizing the Midface.

Purpose: Patients seeking treatment for the midface are individuals with different objectives and characteristics of skin and soft tissue. In this study, patients were treated in the midface with one of three products with different properties; HARV, HARD, or HARL, using a treatment algorithm based on primary need for treatment (volumizing, lifting or contouring) and tissue coverage (thin or thick tissue). The aim was to optimize the treatment outcome and to provide an individualized treatment approach that distinguishes different types of patients seeking midfacial treatment. Materials and Methods: Subjects were treated in the midface at baseline to achieve optimal aesthetic results (≤2 mL per side of the face), and touch-up was allowed after 4 weeks (≤1 mL per side of the face). Study visits were scheduled at Weeks 8, 16 and 24. Assessments included aesthetic improvement of the midface, evaluation of midface fullness, and subject satisfaction. Safety evaluations included local tolerability symptoms collected at 4 weeks after treatment and adverse events. Results: A total of 90 subjects were included in the study, mean age was 45 years (range 29-55) and 82% of subjects were female. Mean total injected volume for the products was 4.4 mL (HARV and HARL) and 4.2 mL (HARD). At least 92% of subjects were assessed as aesthetically improved throughout the study. Assessment of midface fullness showed ≥90% of subjects being responders until Week 24. In addition, subject satisfaction was high throughout the study. Tenderness, bruising and swelling were the most reported local tolerability symptom for all study products, and no adverse events related to study product/treatment were reported. Conclusion: Midface treatment with either HARV, HARD, or HARL using a treatment algorithm to guide the choice of product to individual subject needs was effective and safe for up to 24 weeks after treatment.