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Global Aesthetics Consensus: Botulinum Toxin Type A--Evidence-Based Review, Emerging Concepts, and Consensus
Hema Sundaram1, Massimo Signorini, Steven Liew
1Rockville, Md.; Milan, Italy; Sydney, New South Wales, and Carlton, Victoria, Australia; São Paolo and Rio de Janeiro, Brazil; Beijing, China; Boca Raton, Fla.; Seoul, Korea; and Cannes, France.
Plastic and Reconstructive Surgery
|February 25, 2016
Summary
Botulinum toxin type A injections are evolving beyond the upper face, with new guidelines emphasizing tailored approaches for diverse patients. This shift focuses on neuromodulation for optimal cosmetic results and safety.
Area of Science:
- Aesthetic medicine
- Dermatology
- Plastic surgery
Background:
- Botulinum toxin type A injections are the most popular global nonsurgical cosmetic procedure.
- High efficacy and patient satisfaction rates are documented.
Purpose of the Study:
- To develop updated, global consensus recommendations for botulinum toxin type A and hyaluronic acid fillers.
- To address advances in facial analysis, injection techniques, and complication management for botulinum toxin type A.
Main Methods:
- Convening of the Global Aesthetics Consensus Group, a multinational and multidisciplinary team of plastic surgeons and dermatologists.
- Review of current clinical evidence and expert experience with botulinum toxin type A.
Main Results:
- Botulinum toxin use has expanded to the lower face, neck, and midface.
- An integrative, diagnostic approach is recommended, with dosage and placement based on detailed facial analysis.
- A paradigm shift towards neuromodulation (rather than paralysis) is highlighted, involving lower doses, combination treatments with hyaluronic acid fillers, and specific injection techniques like intracutaneous injections.
Conclusions:
- Clinical experience has refined botulinum toxin treatment planning and implementation.
- The Global Aesthetics Consensus Group advocates for an etiology-driven, patient-tailored approach.
- This approach aims to optimize efficacy and safety in an increasingly diverse patient population.
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