title: Evolution of Facial Aesthetic Treatment Over Five or More Years: A Retrospective Cross-sectional Analysis of Continuous OnabotulinumtoxinA Treatment.
abstract: BACKGROUND
  Little information exists on how facial aesthetic treatments are incorporated into aesthetic regimens.
  
  
  OBJECTIVE
  Assess the evolution of facial aesthetic treatments in patients receiving long-term continuous onabotulinumtoxinA treatment.
  
  
  METHODS
  This international retrospective chart review included patients with ≥5 years of continuous onabotulinumtoxinA treatments including ≥1 glabellar lines treatment/year. Charts were reviewed for facial areas treated, number of treatments, doses/treatment visit, concomitant aesthetic procedures, and onabotulinumtoxinA-related adverse events.
  
  
  RESULTS
  Data were collected from 5,112 onabotulinumtoxinA treatment sessions for 194 patients over an average of 9.1 years. Dosing was relatively stable over time; however, interinjection intervals increased. Glabellar lines' treatment temporally preceded crow's feet lines and forehead lines' treatment. A majority of patients (85%) also received treatment with fillers. Cumulative increases in onabotulinumtoxinA treatments occurred over time and by facial area corresponding with increases in treatments with injectable fillers, energy-based devices, and prescription topical creams. The longer the patients were treated, the younger they perceived themselves to look. Rates of adverse events were low.
  
  
  CONCLUSIONS
  OnabotulinumtoxinA treatment evolved over time, coinciding with growth of the facial aesthetics market. Additional treatment modalities were added as complements to onabotulinumtoxinA. Long-term continuous onabotulinumtoxinA injections are an important component of contemporary facial aesthetic treatment regimens.
authors.affiliation: *Carruthers Clinical Research, Vancouver, Canada; †Sadick Research Group, New York, New York; ‡Dr. Brandt Dermatology Associates, Coral Gables, Florida; §Hospital Do Servidor Publico Municipal, Sao Paulo, Brazil; ‖Aesthetic Eyelid Plastic Surgery, Boca Raton, Florida; ¶Monash University, Clayton, Victoria, Australia; #Cannes Private Clinic, Cannes, France; **Niagara Falls Dermatology and Skin Care Center, Niagara Falls, Canada; ††Allergan, Inc., Irvine, California; ‡‡Peloton Advantage, Parsippany, New Jersey.
authors.forename: Alastair
authors.initials: A
authors.lastname: Carruthers
authors.forename: Neil
authors.initials: N
authors.lastname: Sadick
authors.forename: Frederic
authors.initials: F
authors.lastname: Brandt
authors.forename: Ada Regina
authors.initials: AR
authors.lastname: Trindade de Almeida
authors.forename: Steve
authors.initials: S
authors.lastname: Fagien
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Goodman
authors.forename: Herve
authors.initials: H
authors.lastname: Raspaldo
authors.forename: Kevin
authors.initials: K
authors.lastname: Smith
authors.forename: Sarah
authors.initials: S
authors.lastname: Darmody
authors.forename: Conor J
authors.initials: CJ
authors.lastname: Gallagher
authors.forename: James
authors.initials: J
authors.lastname: Street
authors.forename: Linda
authors.initials: L
authors.lastname: Romagnano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000639:trends; D003357:Cosmetic Techniques / Q000639:trends*; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004954:Esthetics; D005123:Eye; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012649:Self Concept; D015595:Skin Aging / Q000187:drug effects*; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D003879:Dermatologic Agents; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A