Botulinum neurotoxin injections are a valuable treatment modality for many therapeutic indications as well as in the aesthetic field for facial rejuvenation. As successful treatment requires repeated injections over a long period of time, secondary resistance to botulinum toxin preparations after repeated injections is an ongoing concern. We report five case studies in which neutralizing antibodies to botulinum toxin type A developed after injection for aesthetic use and resulted in secondary treatment failure. These results add to the growing number of reports in the literature for secondary treatment failure associated with high titers of neutralizing antibodies in the aesthetic field. Clinicians should be aware of this risk and implement injection protocols that minimize resistance development.

Background:Dermal fillers are used to correct age-related changes in hands.Aims:Assess efficacy and safety of two injection techniques to treat age-related changes in the hands using calcium hydroxylapatite filler, Radiesse®.Settings and Design:This was a prospective, comparative, evaluator-blind, single-center study.Materials and Methods:Radiesse® (0.8 mL/0.2 mL 2% lidocaine) was injected subdermally on Day (D)01, using a needle multipoint technique in one hand (N) and a fan-like cannula technique in the other (C). Assessments were made pre-injection, on D14, Month (M)02, M03 and M05 using the Merz Aesthetics Hand Grading Scale (MAS) and Global Aesthetic Improvement Scale (GAIS). Participants completed questionnaires on satisfaction, pain and adverse events (AEs).Statistical Analysis Used:Data distribution was tested with the Shapiro-Wilk and Levene's tests. The Wilcoxon signed-rank and Chi-square tests were employed to evaluate quantitative and qualitative data, respectively.Results:All 10 participants completed the study, four opted for a M03 touch-up (0.8 mL Radiesse®). Evaluator-assessed mean GAIS scores were between 2 (significant improvement but not complete correction) and 3 (optimal cosmetic result) at each time point. The MAS score improved from D01 to M05 (N: 2.60 to 1.40; C: 2.20 to 1.30). Following treatment, participants reported skin was softer, more elastic, more youthful and less wrinkled. Other than less noticeable veins and tendons on the C hand, no differences in participant satisfaction were noted. All AEs were mild, with no serious AEs reported.Conclusions:Both injection techniques (needle and cannula) demonstrated equivalent clinical efficacy with a comparable safety profile for the correction of age-related changes in hands with Radiesse®.

Objective. Assessment of the efficacy and safety of the correction of age-related neck skin changes with the use of botulinus toxin type A (Xeomin). Materials and methods. The study involved 25 women aged 39—65 enrolled according to the inclusion and exclusion criteria. The patients were administered a single subcutaneous injection of Xeomin 60 U in the neck. The efficacy and safety of this procedure was assessed based on the Global Aesthetic Improvement Scale (GAIS) on Day 14 as well as after 2 and 3 months. Results. High efficacy and safety of intracutaneous Xeomin injections at the submaximum dose of 60 u in the medial and lateral platysma bands have been confirmed clinically. The authors suggest an experimental gradining of the age-related neck making it possible to assess and statistically process clinical results of the new method.

Представлен анализ инволюционных процессов кожи тыльной поверхности кисти. Авторами предложена рабочая классификация морфотипов старения кожи данной зоны как клинико-диагностический инструмент для выбора тактики коррекции.