title: Upper- and mid-face anti-aging treatment and prevention using onabotulinumtoxin A: the 2010 multidisciplinary French consensus--part 1.
abstract: BACKGROUND
  Onabotulinumtoxin A (onabotulinum) has been used for 7 years in the treatment of the aging face. A survey was conducted to identify current practices in France.
  
  
  OBJECTIVE
  To develop consensual practice recommendations for treating the aging upper- and mid-face with onabotulinum.
  
  
  METHODS
  Fifty-seven participants reviewed practices and techniques for each identified upper- and mid-face treatment indication. From data gathered during six regional conferences and from a questionnaire, consensual recommendations were developed.
  
  
  RESULTS
  General considerations, key treatment rules, injection specifics (dose, site, and techniques), associated procedures/treatments, and follow-up were defined for each indication, i.e., glabellar, horizontal forehead, crow's feet and bunny lines, lower eyelid rhytides, and eyebrow repositioning and reshaping. For the consensus participants, current onabotulinum use is a global, both preventive and corrective treatment. In France, judicious lowest effective dose, treatment of multiple sites and adjunctive treatment modalities, such as fillers and peels, lead to satisfactory results for clinicians and patients with a youthful, harmonious, animated and natural looking face.
  
  
  CONCLUSIONS
  Years of experience using onabotulinum result in sophisticated treatment approaches, more specific targeted injections, and a better understanding of facial aging, leading to satisfying therapeutic results for both patients and clinicians.
authors.affiliation: Facial Plastic Surgery Centre, Palais Armenonville, Rond Point Duboys d’Angers, 06400 Cannes, France. doctor@raspaldo.fr
authors.forename: Herve
authors.initials: H
authors.lastname: Raspaldo
authors.forename: Martine
authors.initials: M
authors.lastname: Baspeyras
authors.forename: Philippe
authors.initials: P
authors.lastname: Bellity
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Dallara
authors.forename: Veronique
authors.initials: V
authors.lastname: Gassia
authors.forename: Francois-Rene
authors.initials: FR
authors.lastname: Niforos
authors.forename: Lakhdar
authors.initials: L
authors.lastname: Belhaouari
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003625:Data Collection; D005138:Eyebrows; D005143:Eyelids; D005145:Face; D005546:Forehead; D005602:France; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D012060:Rejuvenation; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A