title: IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations.
abstract: BACKGROUND
  Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A) in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy and tolerability data for incobotulinumtoxinA in various facial aesthetic indications and to give expert consensus recommendations to ensure best clinical practice among Russian clinicians.
  
  
  METHODS
  Thirteen dermatology and/or plastic surgery experts attended meetings held in Paris, France (November 2013), and Moscow, Russia (March 2014). The expert group reviewed and analyzed the existing evidence, consensus recommendations, and Russian experts' extensive practical experience of incobotulinumtoxinA in aesthetics to reach consensus on optimal doses, potential dose adjustments, and injection sites of incobotulinumtoxinA for facial aesthetics.
  
  
  RESULTS
  All experts developed guidance on the optimal doses for incobotulinumtoxinA treatment of different regions of the upper and lower face. The expert panel agreed that there are no differences in the efficacy and duration of the effect between the four BoNT/As that are commercially available for facial aesthetic indications in Russia and that, when administered correctly, all BoNT/As can achieve optimal results. Experts also agreed that nonresponse to BoNT/A can be caused by neutralizing antibodies.
  
  
  CONCLUSIONS
  On the basis of the scientific and clinical evidence available for incobotulinumtoxinA, coupled with the extensive clinical experience of the consensus group, experts recommended the optimal doses of incobotulinumtoxinA effective for treatment of wrinkles of the upper and lower face to achieve the expected aesthetic outcome. These first Russian guidelines on the optimal use of incobotulinumtoxinA for augmentation of glabellar lines, periorbital wrinkles, forehead lines, bunny lines, perioral wrinkles, depressor anguli oris, mentalis, masseters and platysmal bands, and performing the Nefertiti lift, are presented here.
authors.affiliation: Department of Dermatovenereology and Cosmetology, Pacific State Medical University, Vladivostock, Russia.
authors.forename: Yana
authors.initials: Y
authors.lastname: Yutskovskaya
authors.affiliation: Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Gubanova
authors.affiliation: Department of Plastic Surgery, IP Pavlov Medical State University, St Petersburg, Russia.
authors.forename: Irina
authors.initials: I
authors.lastname: Khrustaleva
authors.affiliation: Department of Reconstructive and Plastic Surgery, SN Fedorova, Federal State Institution, Novosibirsk, Russia.
authors.forename: Vasiliy
authors.initials: V
authors.lastname: Atamanov
authors.affiliation: Clinic Ideal, Laser Technologies Center, Moscow, Russia.
authors.forename: Anastasiya
authors.initials: A
authors.lastname: Saybel
authors.affiliation: Aestima-clinic, St Petersburg, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Parsagashvili
authors.affiliation: Clinic "Academy", St Petersburg, Russia.
authors.forename: Irina
authors.initials: I
authors.lastname: Dmitrieva
authors.affiliation: Eklan Medical Center of Cosmetological Correction, Moscow, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Sanchez
authors.affiliation: Clinic of Aesthetic Medicine and Plastic Surgery, Moscow, Russia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Lapatina
authors.affiliation: Department of Cosmetology, II Mechnikov North-Western State Medical University, St Petersburg, Russia.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Korolkova
authors.affiliation: Plastic Surgery Clinic, Center of Aesthetic Medicine and Beauty Cosmetology, Tyumen, Russia.
authors.forename: Alena
authors.initials: A
authors.lastname: Saromytskaya
authors.affiliation: "Neo-Clinic," Tyumen, Russia.
authors.forename: Elena
authors.initials: E
authors.lastname: Goltsova
authors.affiliation: Botulinum Toxin Therapy Department, Diagnostic Center of the Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia.
authors.forename: Elmira
authors.initials: E
authors.lastname: Satardinova
keywords: Russia; aesthetics; consensus guidelines; dosage; facial lines; free from complexing proteins; incobotulinumtoxinA