Objectives: To find clear instructions to specifically tighten certain mimic muscle groups, so we can more easily perform Botox treatment. This involved m. levator labii superioris et aliquae nasi, m. depressor anguli oris, m. mentalis and the m. platysma.

Introduction: There is an increase in ‘off-label’ use of BTX in the face, these 'advanced indications' are not yet properly investigated. There is a need for accurate registration of muscles in the face, both anatomic and dynamic.

Materials / method: A total of 20 volunteers were recruited and their faces were videorecorded after different instructions. All muscles on video-stills were classified by three independent experts from 0 (no contraction) to 5 (about maximum contraction). The m. orbicularis oculi was also investigated.

Results: A total of 12 most relevant instructions could be identified.

Conclusion: It was possible to identifie at least one relevant instruction for all muscles mentioned above.

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Objectives: The objective is to create awareness of the serious consequences of Bruxism and its role on premature aging of the lower face.

Introduction: Bruxism is a misdiagnose, misunderstood, disregarded and mistreated condition that it is accelerating the aging of the lower third of the face. This is specially seen on Generation X, and millenials.

Materials / method: powerpoint lecture that will create awareness on how to screen, treat and counsel our patients for a better aesthetic outcome of the lower third of the face and prevent associated medical conditions such as vertigo, migraines, ringing of the ear, etc.

Results: At home health care and treating muscles of mastication with neurotoxins is a great approach to alleviate this epidemic.

Conclusion: At the end of this presentation the attendee will be more aware of this issue and will start screening and treat patients that are suffering from Bruxism

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Objectives: The primary objective of the APPEAL study was to assess overall subject satisfaction of glabellar lines (GL) treatment after 3 injection cycles of abobotulinumtoxinA (aboBoNT-A). Secondary objectives included a description of injection practices, with a focus on interval times between injection cycles.

Introduction: Hyperfunctional lines, such as GL, are caused by prolonged contraction of facial muscles and can lead to wrinkles, negative facial expressions or an aged appearance. Severe GL can have a negative psychological impact on a patient. Botulinum neurotoxin type A injections can temporarily weaken hyperfunctional muscles, and repeated treatments are required to maintain therapeutic advantage. The APPEAL study assessed subject and physician satisfaction of long-term GL treatment with aboBoNT-A in a real-life setting. Here we present injection interval data between Cycles 1 and 2, and 2 and 3.

Materials / method: The APPEAL study (NCT02353897) was a multicentre, non-interventional, prospective, longitudinal study in subjects with moderate-to-severe GL, who received ≥3 cycles of aboBoNT-A injections. Subjects completed a subject satisfaction questionnaire 3 weeks (±7 days) after each cycle. Shortest injection interval was 12 weeks, according to the local summary of product characteristics (SmPC) and maximum interval time was 6 months, determined at the investigators discretion. Descriptive statistics were performed for injection interval times overall, between Cycles 1 and 2, and between Cycles 2 and 3.

Results: After Cycle 3, 99% of subjects (n=134/135) were ‘very satisfied’ (74%) or ‘satisfied’ (25%) with GL correction. Median drug exposure was 309.5 days (range, 1–426 days). 137 (91%) subjects received 3 injection cycles, 3 (2%) received 2 cycles and 10 (7%) received 1 cycle. Overall interval data were available for 140 subjects. Median overall interval time (days [range]) was 10.6 months (320 [228–426] days). Median injection interval time (days [range]) was 5.0 months (152 [85–267] days) between Cycles 1 and 2 (n=140), and 5.3 months (161 [104–211] days) between Cycles 2 and 3 (n=137).

Conclusion: In the APPEAL study, there was a high level of satisfaction following 3 injection cycles of aboBoNT-A. Furthermore, physicians’ injection practices and the interval time between injection cycles aligned with the recommendations of local SmPCs, with a median retreatment interval of 5 months.

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Objectives: To present subject satisfaction data collected after aesthetic treatment of glabellar lines with AbobotulinumtoxinA (ABO) in two published prospective non-interventional multi-centre studies.

Introduction: Subject satisfaction with aesthetic treatments is receiving increasing attention, and is being recognized as a key factor for treatment success.

Materials / method: Subjects aged ≥18 years with moderate-to-severe glabellar lines were included in two prospective non-interventional studies conducted at 79 centres in 10 countries. In both studies, ABO was administered in accordance with routine clinical practice. Follow-up extended to 4 months after one injection cycle in one of the studies, and to 3 weeks after the last of three injection cycles (done 3-6 months apart) in the other study. Subject satisfaction questionnaire data from both studies are presented here.

Results: 709 subjects were enrolled; ≥90% were women. In the study with one injection cycle, the mean baseline dose was 54.7 U* (women) and 65.0 U (men). In the study with three injection cycles, the mean dose was 45.5-46.0 U/cycle. Subject satisfaction was high in both studies. At 3 weeks after the initial injection cycle, ≥95% of subjects were satisfied with the aesthetic outcome; ≥98% reported natural-looking results. The level of subject satisfaction was consistent across injection cycles.
*ABO-specific units

Conclusion: Aesthetic treatment of moderate-to-severe glabellar lines with ABO in accordance with routine clinical practice resulted in high subject satisfaction after the initial injection cycle in both studies. The level of subject satisfaction was consistent across injection cycles (done 3-6 months apart).

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请注明名称（个人，公司，学会等等）: The study was funded by Galderma.

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请注明名称（个人，公司，学会等等）: I am a consultant for IBSA International.

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这项工作的完成感谢以下机构的支持： Galderma Aesthetics

Objectives: Although retrospective data on the repeat use of incobotulinumtoxinA are available, prospective safety and efficacy data for the combined treatment of upper facial lines (UFL) in more than two consecutive dosing cycles are needed.

Introduction: This study investigated the safety, tolerability, and efficacy of repeat-dose injections of incobotulinumtoxinA in the combined treatment of UFL, i.e. glabellar frown lines (GFL), horizontal forehead lines (HFL), and lateral periorbital lines (LPL).

Materials / method: 140 adults with moderate-severe UFL on the Merz Aesthetics Scales (MAS) at maximum contraction were treated with 54-64 U of incobotulinumtoxinA (GFL, 20 U; HFL, 10- 20 U; LPL, 24 U) in up to four, 120-day treatment cycles. Investigator-assessed MAS scores were evaluated for each treated area at maximum contraction on Day 30 [responder = score of “none” (0) or “mild” (1)] of each cycle. Subject-assessed scores for overall appearance of the upper face [responder = score of “much improved” or “very much improved”] were noted at Day 30 of each cycle on the Global Impression of Change Scale (GICS).

Results: Mean units per cycle ranged from 56.3-57.7 U in 125 subjects. 71.4% of subjects experienced a treatment emergent AE (TEAE), and 17.1% a treatment-related AE, with headache as the most common (7.9%). TEAEs continuously decreased over consecutive cycles (12.9%, 5.3%, 3.1% and 1.6%, respectively). No formation of neutralizing antibodies was noted. High responder rates (≥80%) were assessed by the investigator according to MAS for all treated areas and each cycle at day 30. A ~80% responder rate was confirmed for overall appearance of the upper face according to GICS in all four cycles at day 30.

Conclusion: Repeat dose injection of incobotulinumtoxinA for the combined treatment of UFL is safe, efficacious and well tolerated without formation of neutralizing antibodies. It provides natural but long lasting results, and therefore results in a high patient satisfaction.

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这项工作的完成感谢以下机构的支持： Merz Pharmaceuticals, GmbH