title: Combining Microfocused Ultrasound With Botulinum Toxin and Temporary and Semi-Permanent Dermal Fillers: Safety and Current Use.
abstract: BACKGROUND
  A microfocused ultrasound system with visualization (MFU-V) is currently indicated for use as a noninvasive dermatological aesthetic treatment to lift the eyebrows, lax submental and neck tissue, and improve lines and wrinkles of the décolleté.
  
  
  OBJECTIVE
  To determine the existence of any safety signals when combining MFU-V with botulinum toxin-A and/or semipermanent and temporary dermal fillers.
  
  
  METHODS
  A retrospective chart review was performed using subjects who received aesthetic treatments including incobotulinumtoxinA injection, cohesive polydensified matrix hyaluronic acid (CPM HA) dermal fillers, and calcium hydroxylapatite (CaHA) dermal fillers within 6 months of treatment with MFU-V in the same or different anatomic areas.
  
  
  RESULTS
  All subjects (N = 101; 96 female; 25-70 year old) received MFU-V, 18% received incobotulinumtoxinA injections, and 81% were treated with CPM HA and/or CaHA fillers. Seven adverse events (7%) were reported: bruising/purpura (n = 4), swelling (n = 1), paresthesia (n = 1), and herpes simplex virus (HSV) outbreak (n = 1). Only the HSV outbreak was considered to be related to combined treatments.
  
  
  CONCLUSIONS
  Although limited by relatively few subjects, the results of the present study suggest that the safety profile of MFU-V combined with other aesthetic products is consistent with the safety profiles of the individual treatments.
authors.affiliation: *Dermatology Cosmetic Laser Medical Associates of La Jolla, San Diego, California; †Aesthetic Plastic Surgical Institute, Laguna Beach, California; ‡Premier Clinical Research, Spokane, Washington; §Skin Associates of South Florida, Coral Gables, Florida; ‖Maryland Laser Skin and Vein Institute, Hunt Valley, Maryland; ¶Apothekon Inc., Woodbury, Minnesota.
authors.forename: Sabrina G
authors.initials: SG
authors.lastname: Fabi
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Mills
authors.forename: W Philip
authors.initials: WP
authors.lastname: Werschler
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Green
authors.forename: Joely
authors.initials: J
authors.lastname: Kaufman
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weiss
authors.forename: Carl S
authors.initials: CS
authors.lastname: Hornfeldt
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000009:adverse effects*; D003131:Combined Modality Therapy / Q000009:adverse effects; D003288:Contusions / Q000209:etiology; D003357:Cosmetic Techniques / Q000009:adverse effects; D000067548:Dermal Fillers / Q000009:adverse effects*; D017886:Durapatite / Q000009:adverse effects; D005145:Face; D005260:Female; D006561:Herpes Simplex / Q000209:etiology; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects*; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009333:Neck; D009465:Neuromuscular Agents / Q000009:adverse effects*; D011693:Purpura / Q000209:etiology; D012189:Retrospective Studies; D015595:Skin Aging; D013909:Thorax
chemical_list: D000067548:Dermal Fillers; D009465:Neuromuscular Agents; D006820:Hyaluronic Acid; D017886:Durapatite; D019274:Botulinum Toxins, Type A; C545476:incobotulinumtoxinA