Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): GE consultant

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: To compare the efficacy and safety of the injectable neuromodulator, prabotulinumtoxinA, for the treatment of moderate to severe glabellar lines between millennial (born 1982-2000, n=65) and non-millennial (born ≤1981, n=668) patients who participated in the three single-dose Phase III glabellar line clinical studies. Importantly, both cohorts were similarly matched at baseline in the severity of their glabellar lines at maximum frown, as measured on the 4-point Glabellar Line Scale (GLS: 0=none, 1=mild, 2=moderate, 3=severe).

Introduction: Millennials, as defined by the US Census Bureau, were born between 1982 and 2000. Millennial use of aesthetic products is increasing – particularly of those products that are both minimally invasive and can be used preventatively. At the same time, there is a paucity of published clinical trial data in this population.

Materials / method: Post-hoc analyses were performed on the pooled population of all 733 patients treated with 20U prabotulinumtoxinA in the single-dose studies. At the time that these studies were conducted (Jan-Nov 2015), millennial patients were 21-33 years and non-millennial patients were 33-81 years. One of the main efficacy endpoints was the proportion of responders with a ≥1 point improvement from baseline at maximum frown on the 4-point GLS. Global aesthetic improvement and subject satisfaction were also assessed, and treatment-related adverse events of particular interest were summarized.

Results: The proportion of millennial responders with a ≥1 point improvement from baseline on the GLS at maximum frown was greater than that of non-millennials by 7.7% on average across all visits. Differences were statistically significant on Day 90, with responder rates of 90.2% and 76.1%, respectively (p=0.01). Similar trends were observed for global aesthetic improvement and subject satisfaction. Treatment-related headache was observed in 9.0% of millennials and 9.4% of non-millennials; treatment-related eyelid ptosis was observed in 1.5% of millennials and 1.2% of non-millennials.

Conclusion: As evident in these post-hoc analyses, despite similarities in the severity of glabellar lines at maximum frown at baseline, a single dose of 20U prabotulinumtoxinA administered for the treatment of moderate to severe glabellar lines was consistently more efficacious in millennials than non-millennials. Satisfaction among millennials remained very high throughout the study. The treatment was similarly well-tolerated by both cohorts.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): augmented anatomy

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
Yes
Please specify date...: approved
and status : 2020

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: The botulinum toxin 'lip flip' procedure has certainly received recognition on social media, promising results in all patients. This presentation will critically review the publications behind this, the anatomical aspects that contribute to efficacy of the treatment and also case studies of the author using the Vectra 3D analysis to measure results.

Introduction: Achieving lip eversion through relaxation of the peri-oral muscles requires an in-depth knowledge of the anatomical relation of the peri-oral muscles. The orbicularis Morsi muscle has deep and superficial parts, marginal and peripheral parts and also has fibers interacting with other elevator muscles as well as depressor muscles. Successful eversion of the lip not only requires this insight, but also an understanding of the limitations, the ideal type of patient and the risks of the procedure.

Materials / method: 1. Literature review of publications that include lip enhancement of botulinum toxin and' or orbicularis oris muscle treatment with botulinum toxin.
2. Clinical case studies of patients treated with botulinum toxin for lip eversion using the Vectra 3D analysis for accurate measurements.

Results: The results of the literature review of publications will be discussed as well as the results of the clinical case studies of using botulinum toxin for lip eversion or lifting

Conclusion: Lip eversion can be achieved with the use of botulinum toxin injections at the precise location where the specific orbicularis oris fibers inverts the lip, avoiding spread to elevator parts of the muscle or other elevators interacting with the muscle. The treatment is effective, but has limitations with regard to duration and in specific types of patients. The treatment is ideal for combination with other peri-oral treatments.
A good understanding of the procedure will help the physician to perform it in the most suitable patient and in the most effective method.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: assess how to treat a very diffused condition according to anatomy, real needs and possible materials

Introduction: Gummy smile is a very diffused condition characteriscit in some populations as middle east and far east, where often is connected with a retrusion of the chin.

Materials / method: all possible types of gummy smiles have been studied, their origin and possible therapies.
the use of injectables as BoNT-A and Fillers is underlined and results presented

Results: results are good even if patients sometimes complain of the finctional sensation.

Conclusion: Gummy smile rarely is a pathology. More times is an anesthetical condition that some patients ask to improve. In these cases we have some medical weapons we can use with very good outcome. Since the good outcome is often connected with a disconfortable sensation, caution is very important to avoid long lasting complains.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
Yes
Please specify entities (individual, company, society): fillmed, ipsen, oeo firenze

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: To give some objective and subjective criteria on how to choose a botulinumtoxin

Introduction: All toxins coming to the market are approved botulinum toxin A products. Therefore, they basically have the same sound background of good clinical trials. However, when you have them in your hands you will realize that they differ when it comes to efficacy and duration of effect. So which criteria to use?

Materials / method: Eminence based including a rough search of the literature

Results: If you are looking for high efficacy and long duration you need to choose the toxins with the presumably highest 150kD content per vial. There is no study which compares ALL available toxins. However, there might be some studies that could be helpful: (1) non-inferiority studies (2) studies in male patients E.g. if a toxin as a good as the compared one and is going in the direction of superiority that’s not a bad sign same as if a toxin does well in male patients. Softer criteria are marketing descriptions and prize. Giving 'natural results' and a lower prize might point to less 150kD per vial

Conclusion: All toxins on the market are safe and efficacious but they may vary in 150KD content. To obtain similar results some toxins might need to be dosed higher as the labeled dosage. Clinical study data might give you some hints as well as prizing. Last not least – or may be the best - try the toxin yourself and see how it works with the labeled dosage in your patients.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability