A Comprehensive Approach to Multimodal Facial Aesthetic Treatment

Narurkar, Vic A.; Cohen, Joel L.; Dayan, Steven H.; Kaminer, Michael S.; Rivkin, Alexander; Shamban, Ava; Sykes, Jonathan M.; Teller, Craig; Weinkle, Susan; Werschler, William Philip; Drinkwater, Adrienne; Pucci, Michael L.; Gallagher, Conor J.

doi:10.1097/dss.0000000000000743

Cited by 37 publications

(14 citation statements)

References 29 publications

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“…While their administration is aimed to be standardized and is licensed for specific indications by the Medicines Health Regulatory Agency (MHRA) in the United Kingdom, the overall consideration and use is where practitioners often seek to differentiate themselves through novel techniques of administration or purported differential understandings of achieving 'facial harmony'. 4,5 Place or location of a clinic is often perceived as a signal of competence and quality, and no address exemplifies this better than Harley Street, in London, 6 which for over 200 years has been associated with high-end specialist care. However, overcrowding and an increased density of providers drives competition leading to some practitioners having to look to differentiate or promote themselves further.…”

Section: To Further Understand Industry Rivalry We Leverage Jeromementioning

confidence: 99%

“…The products being considered are both botulinum toxin and dermal fillers. While their administration is aimed to be standardized and is licensed for specific indications by the Medicines Health Regulatory Agency (MHRA) in the United Kingdom, the overall consideration and use is where practitioners often seek to differentiate themselves through novel techniques of administration or purported differential understandings of achieving ‘facial harmony’ 4,5 …”

Section: Introductionmentioning

confidence: 99%

“…[london] botulinum toxin,(3) [london] anti-wrinkle injection,(4) [london] filler,(5) [london] dermal filler. One hundred websites per search string were systematically reviewed and those which met the inclusion/exclusion criteria of each search string were included and analyzed.…”

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confidence: 99%

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Cosmetic business mechanics in London: A cross‐sectional analysis and audit of ASA compliance

Zargaran

Sousi

et al. 2023

J of Cosmetic Dermatology

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Introduction The proliferation of providers and practitioners of cosmetic botulinum toxin and dermal filler has profound public health implications. The Advertising Standards Authority (ASA) regulates the use of advertising materials in the United Kingdom and prohibits the promotion of prescription‐only medicines. Aims We aim to perform a cross‐sectional analysis of the practitioners in London, UK to evaluate the distribution of clinics within Greater London, prices advertised for interventions, and compliance with the ASA code. We also aim to identify whether there are any differences in cost of botulinum toxin or dermal filler between the boroughs. Methods Between December 2021 and January 2022, we performed a systematic search using the internet search engine Google. Five searches were performed (1) [london] botox, (2) [london] botulinum toxin, (3) [london] anti wrinkle injection, (4) [london] filler, (5) [london] dermal filler. One hundred websites per search string were systematically reviewed and those which met the inclusion/exclusion criteria of each search string were included and analyzed. Each clinic's product/service range compliance with the ASA/CAP code was assessed. Any reference to Botulinum Toxin or anti‐wrinkle injections was noted and analyzed. Further analysis would look to calculate price per milliliter (mL) of botulinum toxin and dermal filler per borough and to calculate whether there were any statistical differences between the 32 different London boroughs. Results A total of 500 websites were visited and evaluated. After removal of duplicates, a total of 233 independent clinics was identified. A total of 206 out of the 233 clinics sampled (88%) were in direct infringement of the enforcement notice through advertising a prescription medicine. The overall average cost per mL of dermal filler was £330.89 and there was a statistically significant variance across London boroughs (p < 0.05). The overall average cost per mL of Botulinum Toxin was £284.45 and the variance across London boroughs was close to significant (p = 0.058). Conclusion This paper demonstrates poor compliance with the ASA/CAP guidelines and further provides an insight into the industry mechanics associated with aesthetic injectables in a major UK city, identifying regional variance in price and clinic density. The advertising of prescription‐only medication may pose a potential risk to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.

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Section: To Further Understand Industry Rivalry We Leverage Jeromementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cosmetic business mechanics in London: A cross‐sectional analysis and audit of ASA compliance

Zargaran

Sousi

et al. 2023

J of Cosmetic Dermatology

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“…due to its reported pharmacological properties which includes antiaging (Bukhari et al, 2018), anti-inflammatory (Chen, 2018), skin repairing (Narurkar et al, 2016), tissue regeneration (Bukhari et al, 2018) and wound recovery properties (Chen, 2018). HA possess good biocompatibility, high moisture retention, and tuneable viscoelastic properties (Sze et al, 2016).…”

Section: Structural and Functional Characteristics Of Hyaluronic Acidmentioning

confidence: 99%

Hyaluronic Acid-Mediated Drug Delivery System Targeting for Inflammatory Skin Diseases: A Mini Review

et al. 2020

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Hyaluronic acid (HA), a major component of extracellular matrix has been widely applied in pharmaceutical and cosmetic industries due to its reported pharmacological properties. Various types of HA drug delivery system including nanoparticles, cryogel-based formulations, microneedle patches, and nano-emulsions were developed. There are studies reporting that several HA-based transdermal delivery systems exhibit excellent biocompatibility, enhanced permeability and efficient localized release of anti-psoriasis drugs and have shown to inhibit psoriasis-associated skin inflammation. Similarly HA is found in abundant at epidermis of atopic dermatitis (AD) suggesting its role in atopic AD pathology. Anti-allergenic effect of atopic eczema can be achieved through the inhibition of CD44 and protein kinase C alpha (PKCa) interaction by HA. Herein, we aim to evaluate the current innovation on HA drug delivery system and the other potential applications of HA in inflammatory skin diseases, focusing on atopic dermatitis and psoriasis. HA is typically integrated into different delivery systems including nanoparticles, liposomes, ethosomes and microneedle patches in supporting drug penetration through the stratum corneum layer of the skin. For instance, ethosomes and microneedle delivery system such as curcumin-loaded HA-modified ethosomes were developed to enhance skin retention and delivery of curcumin to CD44-expressing psoriatic cells whereas methotrexate-loaded HA-based microneedle was shown to enhance skin penetration of methotrexate to alleviate psoriasis-like skin inflammation. HA-based nanoparticles and pluronic F-127 based dual responsive (pH/temperature) hydrogels had been described to enhance drug permeation through and into the intact skin for AD treatment.

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“…It has been acknowledged that expert advice may provide valuable guidance for a multi-modal approach to aesthetic treatment. 55 Parts of the available guidelines are focused on specific subpopulations, according to patients' ethnic origin, gender, or age 6,18,19,53,54,56 as the achievement of optimal outcomes results from a patient-centred treatment plan that accounts for facial morphotype as well as personal and cultural aesthetic ideals. 18,19 Indeed, facial morphology and age-related changes differ across ethnic groups, 54 which result in distinct treatment goals and priorities or components of combination treatments.…”

Section: Touch Up (Optional)mentioning

confidence: 99%

<p>Minimally Invasive Aesthetic Treatment of the Face and Neck Using Combinations of a PCL-Based Collagen Stimulator, PLLA/PLGA Suspension Sutures, and Cross-Linked Hyaluronic Acid</p>

Melo

Carrijo²,

Hong³

et al. 2020

CCID

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Background: Combinations of minimally invasive procedures (MIPs) are often used in aesthetic treatments and are increasingly considered as the new standard of care. Three agents with specific properties are available in this perspective: a polycaprolactone (PCL)based collagen stimulator, a poly-L-lactic acid (PLLA)-and a poly-glycolic acid (PLGA)based resorbable suspension suture with a 3D-cone technology, and a cross-linked hyaluronic acid (HA). Objective: To develop the first practice guidelines on rejuvenation treatment of the face and the neck using combinations of these agents, whether associated or not with other widely used MIPs such as botulinum neurotoxins or energy-based devices. Methods: A multidisciplinary , multinational board of plastic surgeons and dermatologists convened to develop guidelines using a predefined consensus method. The consensus was defined as ≥83% agreement rate between participants. Results: Practice guidelines and algorithms, describing optimal procedure sequence and spacing, are proposed for the treatment of upper-, mid-, lower-face and neck, combining the PCL collagen stimulator, the PLLA/PLGA suspension sutures, and the cross-linked HA, whether associated or not with other MIPs. Conclusion: These new guidelines provide general support to optimal management strategies. Individual treatment plans should be adapted according to the physician's individual competence and the patient's preferences.

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A Comprehensive Approach to Multimodal Facial Aesthetic Treatment

Abstract: The investigators' perspectives and experience with the injection pattern, sequencing, volumes, and techniques may provide valuable guidance for a multimodal approach to facial aesthetic treatment.

Cited by 37 publications

References 29 publications

Cosmetic business mechanics in London: A cross‐sectional analysis and audit of ASA compliance

Cosmetic business mechanics in London: A cross‐sectional analysis and audit of ASA compliance

Hyaluronic Acid-Mediated Drug Delivery System Targeting for Inflammatory Skin Diseases: A Mini Review

<p>Minimally Invasive Aesthetic Treatment of the Face and Neck Using Combinations of a PCL-Based Collagen Stimulator, PLLA/PLGA Suspension Sutures, and Cross-Linked Hyaluronic Acid</p>

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