No abstract
PURPOSE: FDA approved formulations of botulinum toxin include (onabotulinumtoxinA) Botox®, (abobotulinumtox-inA) Dysport®, and (incobotulinumtoxinA) Xeomin®. Prior comparative studies have relied upon static photographic wrinkle scales to determine toxin efficacy, without measuring true dynamic outcomes. Here our group uses Digital Image Correlation (DIC) to precisely compare dynamic strain reduction between available neurotoxins. METHODS: 68 BoNTA-naïve female patients between the ages of 18-75 were recruited. Following baseline imaging of dynamic glabellar furrow, patients were randomized to injection with 20 units of onabotulinumtoxinA, 60 units of abob-otulinumtoxinA, or 20 units of incobotulinumtoxinA into the glabella by a single trained injector. Reimaging was conducted 4 and 14 days following injection. Change in average dynamic strain was calculated and compared between groups at all time points via student's t test. RESULTS:At day 4 post injection, patients receiving onabotu-linumtoxinA had a 33.2% decrease in dynamic glabellar compression compared to 28.7% for abobotulinumtoxinA (p = 0.76) and 22.8% for incobotulinumtoxinA (p = 0.5). At day 14 post injection, patients receiving onabotulinumtoxinA had a 62% decrease in strain, compared to 57.6% for abobotulinumtoxinA (p = 0.51) and 51.7% for incobotulinumtoxinA (p = 0.26). At day 4, onabotulinumtoxinA achieved 53% maximal efficacy, compared to 49% and 44% for abobotulinumtoxinA and incobotu-linumtoxinA, respectively. There was no correlation between patient age, Glogau or Fitzpatrick scales and strain reduction. CONCLUSION:OnabotulinumtoxinA, incobotulinumtox-inA, and abobotulinumtoxinA are all effective at glabellar strain reduction. However, within 14 days post injection, there is a strong trend towards superiority of onabotulinumtoxinA in strain reduction efficacy. PURPOSE: Suction-assisted lipectomy, or liposuction, is the most commonly performed aesthetic surgical procedure in the US according to the ASAPS Cosmetic National Database (363,912 procedures performed in 2013). Liposuction is being performed increasingly in combination with other surgical procedures to enhance outcomes. This study analyzed the risk factors and significant complications after liposuction, alone and in combined procedures. METHODS:Prospectively enrolled patients undergoing liposuction between 2008 and 2013 were identified from the CosmetAssure database (total of 183,914 procedures). Cos-metAssure is an insurance program that provides coverage for treatment of significant complications following aesthetic surgery. Univariate and multivariate analysis was performed on identified risk factors including age, smoking, BMI, gender, diabetes, multiple procedures and type of surgical facility. RESULTS:A total of 31,010 liposuction procedures were identified; 11,490 (37.1%) were performed as a solitary procedure. The incidence of significant complications was 0.7% with liposuction alone, 3.8% when combined with abdominoplasty and 12% when combined with abdominoplasty, breast and an...
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