Publication of a new botulinum toxin article at the canadian congress American Society for Dermatologic Surgery ASDS- Nov2014 in San Diego
Evolution of Facial Aesthetic Treatment Over 5 or More Years: An International, Retrospective, Cross-Sectional Analysis of Continuous OnabotulinumtoxinA Treatment

ABSTRACT:
Objective: Assess the evolution of facial aesthetic treatment in patients receiving long-term continuous treatment with onabotulinumtoxinA.

Study Design: This international, retrospective chart review included patients aged 18 years or older at the time of their first onabotulinumtoxinA aesthetic treatment and a history of 5 or more years of continuous onabotulinumtoxinA treatments (yearly average 2 or more treatments, including 1 or more glabellar lines [GL] treatment/year for 5 or more years). Medical records were reviewed for facial areas treated with onabotulinumtoxinA, number of treatments, dosage per facial treatment area, concomitant facial aesthetic procedures and treatments, and onabotulinumtoxinA-related adverse events (AEs), thus providing extensive data on the progression of patients’ aesthetic treatments and clinical trends during the period of widespread adoption of injectable aesthetic treatments.

Results: Of 207 patients included, 194 met criteria for the per-protocol analysis. Patients were treated with onabotulinumtoxinA for a mean of 9.1±2.9 years (range 5.0-16.8) and data were collected from 5112 treatment sessions, of which 4402 sessions included treatment for GL. Mean age at first injection was 46.3±9.9 years. The longer patients were treated, the younger they perceived themselves to look. GL treatment temporally preceded crow’s feet lines (CFL), followed closely by forehead lines (FHL). Dosing in GL and CFL remained relatively stable over the period 1999 to 2012, although FHL dose decreased. A majority of patients (85%; 165/194) received treatment with fillers, of which 111 began, on average, 38 months after first onabotulinumtoxinA treatment. The remainder received fillers previously (n=25) or began in the same year (n=29). In addition to a cumulative increase in onabotulinumtoxinA treatments in GL, FHL, and CFL over time, there were increases in facial aesthetic treatments with injectable fillers, energy-based devices, and prescription topical creams. AEs were infrequent, mostly mild in severity, and declined markedly over the first year of treatment.

Conclusions: This study shows that continuous onabotulinumtoxinA treatments over several years are safe and can be used in conjunction with other aesthetic treatments. Patients receiving continuous onabotulinumtoxinA treatment perceived themselves to look younger than their actual age.

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