title: Trends in the Use of Neurotoxins and Dermal Fillers by US Physicians.
abstract: BACKGROUND
  Demand for minimally invasive cosmetic procedures have led to an increased market of available products for facial rejuvenation.
  
  
  OBJECTIVE
  To characterize trends in the usage of aesthetic products, specifically the use of botulinum toxins and dermal fillers, by United States physicians.
  
  
  METHODS
  Data from the National Ambulatory Medical Care Survey was analyzed from 1993 to 2010 to evaluate the use of dermal fillers and neurotoxins in the United States outpatient setting. The types of physician specialties administering these products and their preferences in products were characterized.
  
  
  RESULTS
  There were an estimated 100,000 annual cosmetic visits at which a dermal filler was administered from 1993 to 2010. From 2002 to 2010, there were 140,000 annual cosmetic visits for a dermal filler and 440,000 visits for a neurotoxin. While collagen was the most common filler used over the entire study period, its use declined eight percent annually. Hyaluronic acid fillers were preferred from 2002 to 2010, followed by calcium hydroxylapatite filler, representing 50 percent and 16.1 percent of visits, respectively. The leading neurotoxin was onabotulinumtoxin A, used at 87.1 percent of visits. Dermatologists were the leading specialty for the cosmetic use of both dermal fillers and neurotoxins.
  
  
  CONCLUSIONS
  Providers' preference for cosmetic products appears to be influenced by their familiarity with them, with products that first came to market, such as the neurotoxin onabotulinumtoxin A and the hyaluronic acid fillers being used most frequently from 2002 to 2010.
authors.affiliation: Center for Dermatology Research, Departments of Dermatology.
authors.forename: Laura F
authors.initials: LF
authors.lastname: Sandoval
authors.affiliation: Center for Dermatology Research, Departments of Dermatology.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Huang
authors.affiliation: Center for Dermatology Research, Departments of Dermatology.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.affiliation: Center for Dermatology Research, Departments of Dermatology ; Center for Dermatology Research, Departments of Pathology ; Center for Dermatology Research, Departments of Public Health Sciences, Wake Forest School of Medicine; Winston-Salem, North Carolina.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.affiliation: Center for Dermatology Research, Departments of Dermatology.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Taylor