title: Current aesthetic use of abobotulinumtoxinA in clinical practice: an evidence-based consensus review.
abstract: The amount and complexity of scientific and clinical evidence for aesthetic use of botulinum neurotoxin type A (BoNT-A) has expanded rapidly in recent years, especially for abobotulinumtoxinA, necessitating reassessment of current knowledge about aesthetic use of abobotulinumtoxinA and other BoNT-A preparations. A committee of 13 plastic surgeons, facial plastic surgeons, and dermatologists engaged in a live discussion of information from a systematic literature review and an Internet-based survey of their beliefs and practices. The committee achieved consensus on most issues. It was concluded that doses of different BoNT-A preparations cannot be interconverted with a fixed ratio. The size of the "field of effect" is difficult to measure, and comparisons between preparations have yielded equivocal results. Nonresponse due to neutralizing antibodies appears exceedingly rare with currently available BoNT-A preparations and of little concern clinically. BoNT-A dose, injection depth, and injection technique should be adjusted according to the anatomic area being treated and each patient's individual characteristics and goals. Aesthetic use of BoNT-A has a good safety profile. Most adverse events are minor and related to the trauma of injection, although special care is needed in certain anatomic areas. Detailed recommendations for treatment of different anatomic areas are presented. BoNT-A products are often used in conjunction with other treatment modalities (eg, fillers and resurfacing), but little agreement was reached on best practices. The findings reported in this consensus document may serve as a practical guide for aesthetic practitioners as they apply the latest knowledge about BoNT-A in providing their patients with optimal care.
authors.affiliation: University of California-San Francisco, CA 94115, USA.
authors.forename: Corey
authors.initials: C
authors.lastname: Maas
authors.forename: Michael A C
authors.initials: MA
authors.lastname: Kane
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Bucay
authors.forename: Shawn
authors.initials: S
authors.lastname: Allen
authors.forename: David J
authors.initials: DJ
authors.lastname: Applebaum
authors.forename: Leslie
authors.initials: L
authors.lastname: Baumann
authors.forename: Sue Ellen
authors.initials: SE
authors.lastname: Cox
authors.forename: Julius W
authors.initials: JW
authors.lastname: Few
authors.forename: John H
authors.initials: JH
authors.lastname: Joseph
authors.forename: Z Paul
authors.initials: ZP
authors.lastname: Lorenc
authors.forename: Amir
authors.initials: A
authors.lastname: Moradi
authors.forename: Mark S
authors.initials: MS
authors.lastname: Nestor
authors.forename: Joel
authors.initials: J
authors.lastname: Schlessinger
authors.forename: Mitchell
authors.initials: M
authors.lastname: Wortzman
authors.forename: Ira
authors.initials: I
authors.lastname: Lawrence
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Lin
authors.forename: Diane
authors.initials: D
authors.lastname: Nelson
mesh_terms: D057134:Antibodies, Neutralizing / Q000276:immunology; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D003357:Cosmetic Techniques; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D006801:Humans; D007267:Injections; D009498:Neurotoxins / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D057134:Antibodies, Neutralizing; D009498:Neurotoxins; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA