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Objectives: The “dark side of the moon” to living longer is that antagonists to collagens from our environment, including sun and smoking, diet and stress, pollution and lack of sleep, have more time to act on our body.
Collagens are continuously remodeled throughout life. Starting at the age of 21 we lose approximately 1% of our collagens each year, because the ongoing rate of collagen destruction generally exceeds the rate of new collagen synthesis. It is very important to protect our collagen “capital” both by reducing damage and by increasing the new synthesis of collagens.

Introduction: Collagens – yes, because we have more than one type of collagen – are strongly connected with our history as humans, and their importance is highlighted by the fact that collagens represent one-third of our body’s proteins and are involved not only in structural but also in other specific and essential bodily functions.

Materials / method: Synthesis of collagens is a very complex biochemical process that starts in the nucleus and continues both inside and outside collagen generating cells, i.e. fibroblasts. In fact, tens of genes and several enzymes regulate collagen synthesis. On top of that, numerous vitamins, minerals, and amino acids, as well as energy, are involved in these multi-step processes.

Results: Collagens are continuously damaged by various antagonists. Some originating outside, others inside of our body. The first step in protecting our collagens is awareness of these antagonists. The second step consists in developing an individualized anti-aging program, based on lifestyle – attention to sun exposure, sugar and smoking, good sleep, and correct skincare, in addition to the use of laser and other devices. Both the protection of existing collagen and the stimulation of collagen synthesis should be the pillars of such an anti-aging program.

Conclusion: A new concept called “Prejuvenation” can be initiated in our clinical practices. It is best to put patients on a specific program of anti-aging treatments before the clinical signs of aging, such as there are pigmented lesions, wrinkling, enlarged pores, etc., become apparent.
We present the place of new devices and new laser interventions to increase the natural production of collagen.

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请注明名称（个人，公司，学会等等）: Candela Medical

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Objectives: The purpose of this study was to evaluate treatment outcome after providing investigators with general guidance on how to choose between two hyaluronic acid (HA) filler products for subjects seeking cheek augmentation.

Introduction: This was a post-marketing study of two HA fillers, both approved for use in the cheeks, to augment cheek volume or shape the contours of the face. As the number of HA filler products on the market increases, there is a growing need for guidance for treating clinicians, to help simplify their choice of product. Therefore, a treatment guide focused on categorizing the subject’s needs was tested as an aid for the injectors: those needing a projection effect were treated with HA-LYF, a more supportive gel; those needing a contouring/volumizing effect were treated with HA-VOL, a softer gel.

Materials / method: Subjects were assigned to on-label treatment with HA filler HA-VOL or HA-LYF using the guidance above, based on the primary treatment goal. Treatment was administered on Day 1, with optional touch-up at 2 weeks and follow-up visits were conducted at 4 and 8 weeks after the last treatment. Assessments included aesthetic improvement on the Global Aesthetic Improvement Scale (GAIS), subject-perceived age (FACE-Q), subject satisfaction, 3D imaging analysis, naturalness of facial expressions, and adverse events. The primary endpoint was Week 4 improvement on the GAIS, assessed by the investigator.

Results: Each treatment group included 30 women. Investigators rated all subjects in both groups as aesthetically improved on the GAIS at Week 4 and 8 and subject GAIS assessments also achieved similar results. All subjects achieved the treatment goal: projection or contouring. Subjects and investigators agreed that all subjects had natural-looking results, supported by high rates of subject satisfaction. At Week 8, ≥96% felt that the treatment improved their appearance and ≥79% felt better about themselves. Treatment-related adverse events were all non-serious and mainly mild and transient.

Conclusion: Investigators rated all subjects in both treatment groups as aesthetically improved after treatment. The primary aim of the treatment (projection or contouring/volumization) was achieved for all subjects and results were natural-looking. Subject satisfaction was high in both groups post-treatment and the treatments were well tolerated.

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Objectives: To evaluate the long-term safety and effectiveness of a biostimulatory poly-L-lactic acid (PLLA)-containing injectable device as a single treatment regimen for correction of nasolabial fold contour deficiencies after changes in reconstitution and injection procedures.

Introduction: Since the US approval in 2009 of PLLA for aesthetic use, the reconstitution volume has gradually increased in clinical practice. The concept of a larger reconstitution volume, often in combination with addition of lidocaine to the solution, has been developed to enhance the safety for patients undergoing facial injections. Also, the implementation of immediate use without standing time following reconstitution, provides a more flexible reconstitution protocol for health care practitioners.

Materials / method: This was an open-label extension study to follow-up the pivotal study NCT03780244 from Weeks 48 to 96. Subjects that were randomized to treatment with PLLA reconstituted with 8 mL sterile water for injection (also including an additional 1 mL of 2%-lidocaine, no standing time, and using subdermal injections), were eligible for the extension study. Endpoints were collected at Weeks 72 and 96 and included of adverse events, blinded evaluation of nasolabial fold wrinkle severity using a validated wrinkle assessment scale (WAS), aesthetic improvement and FACE-Q evaluation of lines questionnaire.

Results: A total of 38 subject across 4 sites in the US were included, mean age was 54 years (range 38-70). No new adverse events related to study product were reported during the extension study. WAS responder rate defined as at least 1-step improvement was high (≥69%) through Week 96. All subjects (100%) were rated as aesthetically improved by investigators at all timepoints, and 86% of subjects rated themselves as improved. Subject satisfaction in terms of appraisal of nasolabial folds was maintained throughout the study.

Conclusion: PLLA reconstituted with 8 mL also including 1 mL lidocaine, immediate use, and subdermal injections, continued to be well tolerated and with long-lasting effectiveness until Week 96.

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请注明名称（个人，公司，学会等等）: Galderma

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Objectives: Efficacy and safety of glabellar line (GL) treatment using a new ready-to-use liquid abobotulinumtoxinA formulation (ABO solution) was evaluated in a 6-month, double-blind, randomized, placebo-controlled Phase III study (NCT02353871). The post hoc analysis described herein further evaluated ≥1 grade improvement in GL severity over time and subject satisfaction with treatment.

Introduction: Available botulinum toxin type A formulations typically require reconstitution before use. ABO solution has been developed as a convenient ready-to-use formulation to reduce preparation time and improve reproducibility and precision in dose delivery.

Materials / method: Subjects aged 18-65 years, with moderate-to-severe GLs at maximum frown, were randomized 2:1 to treatment with 50 U of ABO solution (n=125) or placebo (n=59). GL severity at maximum frown was assessed for 6 months after treatment by the subjects (SSA) and investigators (ILA), using 4-graded scales. Subjects also reported satisfaction with GL appearance using a 4-graded scale, and rated their psychological well-being using a FACE-Q© scale, for which individual items are presented below. Adverse events (AEs) were collected throughout the study.

Results: GL improvement by ≥1 grade was achieved in 93% of subjects, 2 weeks after ABO solution treatment and sustained in 40% at Month 6 based on ILA, with similar results for SSA. Median time to return to baseline severity was nearly 6 months: 172 days (ILA); 171 days (SSA). Subjects reported increased well-being lasting 6 months after ABO solution treatment (p<0.05 vs. placebo, based on total scores), with a majority of the individual items significantly improved at Month 1 e.g. ‘I like myself’ and ‘I feel attractive’. Treatment-related AEs were non-serious and had mild or moderate intensity.

Conclusion: After treatment with this new ABO solution, GL severity was improved by ≥1 grade for up to 6 months. The median time to return to baseline rating was also nearly 6 months. Improvement in subject-reported psychological well-being and satisfaction with GL appearance was also sustained for up to 6 months. The treatment with ABO solution was well tolerated.

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请注明名称（个人，公司，学会等等）: Galderma

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Objectives: The efficacy and safety of a ready-to-use liquid abobotulinumtoxinA formulation (ABO solution) for treatment of glabellar lines (GLs) were evaluated in two double-blind, randomized, placebo-controlled Phase III studies (NCT02353871; NCT02493946). Data from these two studies were pooled to obtain a larger data set. The objectives were to evaluate efficacy based on investigator live assessments (ILA) and subject self-assessments (SSA) of GL severity and subject satisfaction, and safety for up to 6 months after treatment.

Introduction: Most available botulinum toxin type A formulations require reconstitution before use. ABO solution has been developed as a convenient ready-to-use formulation to reduce preparation time and improve precision and reproducibility in dose delivery.

Materials / method: Subjects aged 18-65 years, with moderate-to-severe GLs at maximum frown, were injected with 50 U of ABO solution (n=250) or placebo (n=122), randomized 2:1. GL severity at maximum frown was assessed for up to 6 months on 4-graded scales, by the subjects (SSA) and investigators (ILA). Subjects also reported time to onset of effect in a 7-day diary, satisfaction with GL appearance, satisfaction with facial appearance (FACE-Q) and psychological well-being (FACE-Q) up to Month 6. Adverse events were collected throughout the studies.

Results: GLs were improved by ≥1 grade in 90% of subjects at Month 1 after injection with ABO solution and 27% at Month 6 (SSA), which was higher than for placebo (<0.0001). Results were similar for ILA. Subject satisfaction FACE-Q items improved significantly with ABO solution compared to placebo up to Month 6 (facial appearance p<0.05 and well-being p<0.01). At Month 6, 26% of subjects were still satisfied with their GL appearance. Onset of effect was reported within 24 h by 24% of Month-1 none-or-mild ILA responders. Treatment-related adverse events were non-serious, with mild or moderate intensity.

Conclusion: ABO solution was effective for correction of GLs, with rapid onset and a duration of effect up to 6 months after injection. GL severity improvement was accompanied by improved subject satisfaction with both appearance and well-being. The treatment of GLs with ABO solution was well tolerated, and the safety profile of ABO solution was consistent with that for the ABO powder formulation.

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