Jean Carruthers1, Cheryl Burgess, Doris Day, Sabrina G Fabi, Kate Goldie, Martina Kerscher, Andreas Nikolis, Tatjana Pavicic, Nark-Kyoung Rho, Berthold Rzany, Gerhard Sattler, Sonja Sattler, Kyle Seo, William Philip Werschler, Alastair Carruthers. 1. *University of British Columbia, Vancouver, Canada; †Center for Dermatology and Dermatologic Surgery, Washington, D.C.; ‡Day Dermatology and Aesthetics, New York City, New York; §Cosmetic Laser Dermatology, San Diego, California; ‖European Medical Aesthetics Ltd., London, United Kingdom; ¶University of Hamburg, Hamburg, Germany; #Victoria Park Medispa, Montreal, Canada; **Private Practice for Dermatology and Aesthetics, Munich, Germany; ††Leaders Clinic, Seoul, Korea; ‡‡RZANY & HUND, Berlin, Germany; §§Rosenparkklinik, Darmstadt, Germany; ‖‖Seoul National University, Seoul, Korea; ¶¶University of Washington, Seattle, Washington.
Abstract
BACKGROUND: The aging process is a complex interplay of intrinsic and extrinsic factors across multiple layers of the face. Accordingly, combining aesthetic interventions targeting different manifestations of aging often leads to better results than single modalities alone. However, no guidelines for a pan-facial approach using multiple interventions have been published to date. OBJECTIVE: To develop consensus recommendations for the optimal combination and ideal sequence of botulinum toxin (BoNT), hyaluronic acid, calcium hydroxylapatite, and microfocused ultrasound with visualization (MFU-V) in persons of all Fitzpatrick skin types. METHODS AND MATERIALS: Fifteen specialists convened under the guidance of a certified moderator. Consensus was defined as approval from 75% to 94% of all participants, whereas agreement of ≥95% denoted a strong consensus. RESULTS: Optimal aesthetic treatment of the face begins with a thorough patient assessment and an individualized treatment plan. Spacing consecutive treatments 1 to 2 weeks apart allows for resolution of side effects and/or to assess results. For same-day treatments, BoNT and fillers may be performed together in either sequence, whereas MFU-V is recommended before injectable agents. CONCLUSION: Expert consensus supports a combination approach using multiple modalities in specific sequence for the safe and effective treatment of the aging face.
BACKGROUND: The aging process is a complex interplay of intrinsic and extrinsic factors across multiple layers of the face. Accordingly, combining aesthetic interventions targeting different manifestations of aging often leads to better results than single modalities alone. However, no guidelines for a pan-facial approach using multiple interventions have been published to date. OBJECTIVE: To develop consensus recommendations for the optimal combination and ideal sequence of botulinum toxin (BoNT), hyaluronic acid, calcium hydroxylapatite, and microfocused ultrasound with visualization (MFU-V) in persons of all Fitzpatrick skin types. METHODS AND MATERIALS: Fifteen specialists convened under the guidance of a certified moderator. Consensus was defined as approval from 75% to 94% of all participants, whereas agreement of ≥95% denoted a strong consensus. RESULTS: Optimal aesthetic treatment of the face begins with a thorough patient assessment and an individualized treatment plan. Spacing consecutive treatments 1 to 2 weeks apart allows for resolution of side effects and/or to assess results. For same-day treatments, BoNT and fillers may be performed together in either sequence, whereas MFU-V is recommended before injectable agents. CONCLUSION: Expert consensus supports a combination approach using multiple modalities in specific sequence for the safe and effective treatment of the aging face.
Authors: Je-Young Park; Jeng-Feng Chen; Hosung Choi; Wilson W S Ho; Ni Nyoman Indra Lesthari; Joyce Teng Ee Lim; Ting Song Lim; Stephen Lowe; Beverly Ong-Amoranto; Vasanop Vachiramon; Rungsima Wanitphakdeedecha; Martina Kerscher Journal: J Clin Aesthet Dermatol Date: 2022-06
Authors: Gerhard Sattler; Martina Kerscher; Ernst Magnus Noah; Welf Prager; Tanja C Fischer; Patricia Ogilvie; Matthias Hofmann; Hanna Dersch; Gemma Odena Journal: Clin Cosmet Investig Dermatol Date: 2020-08-19
Authors: Yates Y Y Chao; Chiranjiv Chhabra; Niamh Corduff; Sabrina Guillen Fabi; Martina Kerscher; Stephanie C K Lam; Tatjana Pavicic; Berthold Rzany; Peter H L Peng; Atchima Suwanchinda; Fang-Wen Tseng; Kyle K Seo Journal: J Clin Aesthet Dermatol Date: 2017-08-01
Authors: Sabrina Fabi; Tatjana Pavicic; André Braz; Jeremy B Green; Kyle Seo; Jani Aj van Loghem Journal: Clin Cosmet Investig Dermatol Date: 2017-10-30