Dermatologists Perceived by PCPs as Having the Most Expertise for Cosmetic Procedures

Primary care physicians (PCPs) recognize dermatologists as the most qualified specialists to perform various cutaneous cosmetic and surgical procedures, recently published findings suggest. Researchers administered an Internet-based survey to physicians in primary care medicine residency programs in the US and received responses from 561 PCPs. Dermatologists were identified as the most qualified specialists to evaluate and biopsy worrisome lesions on the face (95 percent), perform skin cancer surgery (56 percent), inject botulinum toxin (61 percent), inject fillers (55 percent), and perform laser procedures (75 percent). In addition, 70 percent of respondents correctly defined Mohs micrographic surgery (MMS), and 60 percent of respondents selected a fellowship-trained dermatologist as the best physician to perform MMS.
—Dermatol Surg; 2012 Sept 7 E-pub

Full-Face Rejuvenation with Fillers An Emerging Possibility

Full-face rejuvenation using a range of hyaluronic fillers can offer safe, effective results, as well as notable patient satisfaction, new findings indicate. In a six-month study, participants could receive five different fillers from the same range (HA(E)) for up to eight indications (periorbital lines, tear troughs, cheeks, cheek folds, nasolabial folds, upper lip lines, lips, and marionette lines). Outcomes included global aesthetic improvement scores, improvement in each indication, adverse events, local tolerability, and satisfaction. A total of 77 participants with a mean age of 54.5 were enrolled; 48.1 percent had five or more indications treated. Mean total injection volume (baseline and touch-up) per participant was 6.7mL. At six months, 92.1 percent of participants remained at least improved over baseline, 79.7 percent of participants were satisfied or very satisfied with the durability of results, and 63 percent of participants said they felt a lot or much better than before injection. The researchers noted that no specific safety concerns were reported except expected injection site reactions.
— Dermatol Surg; 28 (7 Pt 2):1153-61

SAFE Storage Times for Botulinum Toxins MAY BE LONGER THAN THOUGHT

Assuming standard safe injection techniques are followed, a single vial of onabotulinumtoxinA (BT-A) can be safely administered to multiple patients and, after reconstitution, can be stored beyond the recommended time period of four hours, according to a new study. Investigators examined current clinical practices and expert consensus recommendations regarding the reconstitution and storage of botulinum toxins and conducted an Internet-based study to analyze current practices of members of the ASDS administering botulinum toxins.

Results showed that after product reconstitution, the majority of physicians (68.6 percent) routinely store botulinum toxin for a period of greater than one week and safely use each toxin vial for more than one patient. Not a single case of infection was observed. However, the authors noted that this was a single survey with a 32.2 percent response rate.
—J Am Acad Dermatol; 67(3): 373-8

Reconstituted abobotulinumtoxinA with Preserved Saline Associated with Less Pain

Reconstitution of abobotulinumtoxinA with preserved saline may result in significantly less pain on injection than with preservative-free saline, according to a new study. In a prospective, randomized, double-blind, side-by-side trial in a private practice dermatology office in Boulder, CO, researchers enlisted 20 volunteer patients to receive injections on one side of their face with abobotulinumtoxinA reconstituted with preservative-free saline and with abobotulinumtoxinA reconstituted with preserved saline on the other side. Patients reported their pain on a 10-point visual analogue pain scale after each side was injected. Patients kept a diary for the first 48 hours after treatment to track any continued pain, onset of action, or adverse events.

Researchers then saw the patients at two-week followup visits and recorded any adverse events. They found that 90 percent of patients reported less pain on the side injected with preserved saline than on the side injected with preservative-free saline. In addition, reported pain on the preserved saline side was 60 percent less than on the preservative-free side. Neither the patients nor the investigators noted any difference in onset of action between the two sides.
—Dermatol Surg; 28(6):867-70