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Botulinum toxin type A treatment of platysmal bands
P2905
P2907
Comparison of extrusion forces of different hyaluronic acid dermal fillers Ahmet Tezel, PhD, Allergan Medical, Santa Barbara, CA, United States; Patricia Walker, MD, PhD, Allergan Medical, Santa Barbara, CA, United States To ensure easy injectability in clinical practice, the extrusion force required to inject a hyaluronic acid (HA) dermal filler through a fine needle is of key importance. A consistent and even extrusion force affords control and precision during an injection—thus facilitating easier and more accurate clinical corrections. HA dermal filler formulations vary in their concentration of HA, their amount of crosslinked HA, and in manufacturing processes affecting the consistency of the final product. Some gel particle HA fillers require adding significant amounts of uncrosslinked HA as a lubricant to facilitate extrusion through a fine needle. Their formulation can result in irregular, spiky extrusion force curves. Furthermore, the uncrosslinked HA fraction added for lubricity is degraded in the body in a matter of days, and will, therefore, not contribute to the final volumizing effect or to the persistence of clinical correction. As the result of advances in HA technology, next-generation HA fillers have now been developed that—unlike gel particle suspensions—have a more uniform consistency. This characteristic promotes a more consistent extrusion force that affords easy injectability without the disadvantage of requiring larger amounts of uncrosslinked, clinically irrelevant HA for lubricity.
Deep facial fold correction with a next-generation hyaluronic acid dermal filler Patricia Walker, MD, PhD, Allergan Medical, Santa Barbara, CA, United States; Jane Thomas, Allergan Medical, Santa Barbara, CA, United States; Diane Murphy, MBA, Allergan Medical, Santa Barbara, CA, United States Deep facial folds and wrinkles call for dermal fillers that provide a more volumizing effect than fillers used for more superficial, fine wrinkles. Hyaluronic acid (HA) dermal fillers are particularly effective volumizing agents as the HA attracts and retains water post-injection. Clinicians are interested in how best to correct deep facial folds, i.e., how deep to inject, which injection technique to use, how to avoid adverse events, how long the correction will last, and how often repeat treatments may be required. This poster will present data from a double-blind, randomized, multicenter, comparative clinical trial aimed at assessing optimal fill, persistence of correction, and subject preference using a next generation HA filler in subjects with deep folds. Sponsored by Allergan Medical Aesthetics.
Sponsored by Allergan Medical Aesthetics.
P2908 Botulinum toxin type A treatment of platysmal bands Fredric S. Brandt, MD, Dermatology Research Institute, LLC, Coral Gables, FL, United States; Andres Boker, MD, Harvard Medical Center, Boston, MA, United States; Adelle Quintana, MD, Private practice, Miami, FL, United States; Susie Salviejo, Dermatology Research Institute, LLC, Coral Gables, FL, United States Purpose: To assess the efficacy and tolerability of varying doses of botulinum toxin type A (BoNTA) in the management of moderate to severe platysmal bands.
P2906 The influence of formulation on persistence with hyaluronic acid dermal fillers Ahmet Tezel, PhD, Allergan Medical, Santa Barbara, CA, United States; Patricia Walker, MD, PhD, Allergan Medical, Santa Barbara, CA, United States The introduction of new hyaluronic acid (HA) dermal fillers over the past few years has brought new options for cosmetic dermatology. When selecting HA dermal fillers for optimal persistence of correction, several formulation characteristics need to be considered. This poster describes the science of crosslinking and discusses formulation characteristics of HA fillers that influence clinical persistence of correction, such as the concentration of HA, and the amount of crosslinked HA. Also to be considered is whether the product is formulated as a gel particle suspension or is of uniform consistency. In addition to formulation characteristics, the injection technique, subject variability, and facial movement patterns all play important roles defining clinical outcomes. Persistence of correction of a specific HA dermal filler, therefore, results from the combined influence of many parameters, including the discussed formulation characteristics. Sponsored by Allergan Medical Aesthetics.
AB198
J AM ACAD DERMATOL
Methods: This was a prospective, single-center, open-label study in which women aged 40 to 65 years with platysmal bands of at least 13 (thick, moderate flaccidity) at full contraction on the platysmal band prominence scale (PBPS, 0-4 scale) were randomized to receive BoNTA (Allergan, Inc., Irvine, CA) 50 U, 75 U, or 100 U intramuscularly to the platsymal bands region of the neck, with total dose divided evenly into 15 injection points. Patients were evaluated over a 24-week period. The horizontal rhytids scale (0 = non-detectable to 3 = severe horizontal rhytids) was assessed as a secondary efficacy endpoint. Results: Twenty-two patients were included in the analysis (BoNTA 100 U, n = 8; 75 U, n = 7; 50 U, n = 7). At baseline, all patients had PBPS scores of 3 to 4 (thick to heavy, moderate to severe flaccidity at rest). A 1-point improvement from baseline in PBPS was achieved in 100% of patients at weeks 8 and 12 and 87.5% in each treatment group at week 16. A 2-point improvement from baseline in PBPS was achieved at week 8 in 38%, 50%, and 100% of patients receiving BoNTA 50 U, 75 U, and 100 U, respectively. Corresponding rates at week 12 were 25%, 63%, and 100%, respectively. A 1-point improvement in the horizontal rhytids scale was achieved by at least 75% of patients in each treatment group at week 12. No adverse events were reported during the study. BoNTA had no effect on jaw elevation. Conclusions: BoNTA doses of 50, 75, and 100 U were effective in reducing platysmal bands in women, with effects apparent for up to 16 weeks. One-hundred units (100 U) of BoNTA produced the most marked and long-lasting effects; therefore, this dose may be most suitable for patients with the most severe platysmal bands. This study was supported 100% by Allergan, Inc.
FEBRUARY 2007
P2907
Comparison of extrusion forces of different hyaluronic acid dermal fillers Ahmet Tezel, PhD, Allergan Medical, Santa Barbara, CA, United States; Patricia Walker, MD, PhD, Allergan Medical, Santa Barbara, CA, United States To ensure easy injectability in clinical practice, the extrusion force required to inject a hyaluronic acid (HA) dermal filler through a fine needle is of key importance. A consistent and even extrusion force affords control and precision during an injection—thus facilitating easier and more accurate clinical corrections. HA dermal filler formulations vary in their concentration of HA, their amount of crosslinked HA, and in manufacturing processes affecting the consistency of the final product. Some gel particle HA fillers require adding significant amounts of uncrosslinked HA as a lubricant to facilitate extrusion through a fine needle. Their formulation can result in irregular, spiky extrusion force curves. Furthermore, the uncrosslinked HA fraction added for lubricity is degraded in the body in a matter of days, and will, therefore, not contribute to the final volumizing effect or to the persistence of clinical correction. As the result of advances in HA technology, next-generation HA fillers have now been developed that—unlike gel particle suspensions—have a more uniform consistency. This characteristic promotes a more consistent extrusion force that affords easy injectability without the disadvantage of requiring larger amounts of uncrosslinked, clinically irrelevant HA for lubricity.
Deep facial fold correction with a next-generation hyaluronic acid dermal filler Patricia Walker, MD, PhD, Allergan Medical, Santa Barbara, CA, United States; Jane Thomas, Allergan Medical, Santa Barbara, CA, United States; Diane Murphy, MBA, Allergan Medical, Santa Barbara, CA, United States Deep facial folds and wrinkles call for dermal fillers that provide a more volumizing effect than fillers used for more superficial, fine wrinkles. Hyaluronic acid (HA) dermal fillers are particularly effective volumizing agents as the HA attracts and retains water post-injection. Clinicians are interested in how best to correct deep facial folds, i.e., how deep to inject, which injection technique to use, how to avoid adverse events, how long the correction will last, and how often repeat treatments may be required. This poster will present data from a double-blind, randomized, multicenter, comparative clinical trial aimed at assessing optimal fill, persistence of correction, and subject preference using a next generation HA filler in subjects with deep folds. Sponsored by Allergan Medical Aesthetics.
Sponsored by Allergan Medical Aesthetics.
P2908 Botulinum toxin type A treatment of platysmal bands Fredric S. Brandt, MD, Dermatology Research Institute, LLC, Coral Gables, FL, United States; Andres Boker, MD, Harvard Medical Center, Boston, MA, United States; Adelle Quintana, MD, Private practice, Miami, FL, United States; Susie Salviejo, Dermatology Research Institute, LLC, Coral Gables, FL, United States Purpose: To assess the efficacy and tolerability of varying doses of botulinum toxin type A (BoNTA) in the management of moderate to severe platysmal bands.
P2906 The influence of formulation on persistence with hyaluronic acid dermal fillers Ahmet Tezel, PhD, Allergan Medical, Santa Barbara, CA, United States; Patricia Walker, MD, PhD, Allergan Medical, Santa Barbara, CA, United States The introduction of new hyaluronic acid (HA) dermal fillers over the past few years has brought new options for cosmetic dermatology. When selecting HA dermal fillers for optimal persistence of correction, several formulation characteristics need to be considered. This poster describes the science of crosslinking and discusses formulation characteristics of HA fillers that influence clinical persistence of correction, such as the concentration of HA, and the amount of crosslinked HA. Also to be considered is whether the product is formulated as a gel particle suspension or is of uniform consistency. In addition to formulation characteristics, the injection technique, subject variability, and facial movement patterns all play important roles defining clinical outcomes. Persistence of correction of a specific HA dermal filler, therefore, results from the combined influence of many parameters, including the discussed formulation characteristics. Sponsored by Allergan Medical Aesthetics.
AB198
J AM ACAD DERMATOL
Methods: This was a prospective, single-center, open-label study in which women aged 40 to 65 years with platysmal bands of at least 13 (thick, moderate flaccidity) at full contraction on the platysmal band prominence scale (PBPS, 0-4 scale) were randomized to receive BoNTA (Allergan, Inc., Irvine, CA) 50 U, 75 U, or 100 U intramuscularly to the platsymal bands region of the neck, with total dose divided evenly into 15 injection points. Patients were evaluated over a 24-week period. The horizontal rhytids scale (0 = non-detectable to 3 = severe horizontal rhytids) was assessed as a secondary efficacy endpoint. Results: Twenty-two patients were included in the analysis (BoNTA 100 U, n = 8; 75 U, n = 7; 50 U, n = 7). At baseline, all patients had PBPS scores of 3 to 4 (thick to heavy, moderate to severe flaccidity at rest). A 1-point improvement from baseline in PBPS was achieved in 100% of patients at weeks 8 and 12 and 87.5% in each treatment group at week 16. A 2-point improvement from baseline in PBPS was achieved at week 8 in 38%, 50%, and 100% of patients receiving BoNTA 50 U, 75 U, and 100 U, respectively. Corresponding rates at week 12 were 25%, 63%, and 100%, respectively. A 1-point improvement in the horizontal rhytids scale was achieved by at least 75% of patients in each treatment group at week 12. No adverse events were reported during the study. BoNTA had no effect on jaw elevation. Conclusions: BoNTA doses of 50, 75, and 100 U were effective in reducing platysmal bands in women, with effects apparent for up to 16 weeks. One-hundred units (100 U) of BoNTA produced the most marked and long-lasting effects; therefore, this dose may be most suitable for patients with the most severe platysmal bands. This study was supported 100% by Allergan, Inc.
FEBRUARY 2007