title: Aesthetic Applications of Botulinum Toxin A in Asians: An International, Multidisciplinary, Pan-Asian Consensus.
abstract: BACKGROUND
  Botulinum toxin type A remains the most popular nonsurgical aesthetic treatment worldwide. Previous consensus statements have focused on Caucasians and on Koreans as generally representative of Asians. However, indications and dosages vary among different ethnic groups. This publication reports the results of a multidisciplinary, pan-Asian consensus focusing on incobotulinumtoxinA.
  
  
  METHODS
  A consensus group of plastic surgeons and dermatologists from Asia, Europe, and the United States convened for a live meeting in Asia, followed by a questionnaire-based Delphi procedure. Treatment of Asians in both their native countries and countries of migration was discussed.
  
  
  RESULTS
  For most items, the group achieved a majority consensus. A number of treatment indications, strategies, and dosages were identified in Asians, which are distinct to those previously described for Caucasians due to differences in facial morphotypes, anatomy, and cultural expectations. The group also formulated position statements for intradermal botulinum toxin type A ("mesotoxin"), body shaping with the calves as a paradigm, and reduction of parotid glands. While Asians have previously been considered a homogeneous group for the purposes of aesthetic treatment, this publication considers regional variations. A new classification of Asian facial morphotypes is proposed to aid treatment planning and implementation.
  
  
  CONCLUSIONS
  This is the first pan-Asian consensus for aesthetic use of botulinum toxin type A. Its unique objective is to optimize treatment safety and efficacy for patients of complete or part-Asian ancestry in all regions. The recommendations for incobotulinumtoxinA may be extended with care to other botulinum toxin formulations.
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Hema
authors.initials: H
authors.lastname: Sundaram
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Po-Han
authors.initials: PH
authors.lastname: Huang
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Nai-Jen
authors.initials: NJ
authors.lastname: Hsu
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Chang Hun
authors.initials: CH
authors.lastname: Huh
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Woffles T L
authors.initials: WT
authors.lastname: Wu
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cassuto
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Martina J
authors.initials: MJ
authors.lastname: Kerscher
authors.affiliation: Dermatology, Cosmetic & Laser Surgery, Rockville, Md.; Huang PH Dermatology and Aesthetics, Kaohsiung, Taiwan; and Aesthetics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Dermatological Clinic, Tainan, Taiwan; Seoul National University Bundang Hospital, Seoul, South Korea; Aesthetic Surgery and Laser Centre, Singapore, Singapore; Peking University First Hospital, Beijing, China; University of Modena, Modena, Italy; Division of Cosmetic Sciences, University of Hamburg, Hamburg, Germany; and Seoul National University Hospital, Seoul, South Korea.
authors.forename: Kyle Koo-Il
authors.initials: KK
authors.lastname: Seo