Injectable neurotoxins and fillers: there is no free lunch.


:Injection of neurotoxins and filling agents for the treatment of facial aesthetics has increased dramatically during the past few decades due to an increased interest in noninvasive aesthetic improvements. An aging but still youth-oriented population expects effective treatments with minimal recovery time and limited risk of complications. Injectable neurotoxins and soft tissue stimulators and fillers have filled this niche of "lunch-time" procedures. As demand for these procedures has increased, supply has followed with more noncore cosmetic specialty physicians, as well as unsupervised ancillary staff, becoming providers and advertising them as easy fixes. Despite an excellent record of safety and efficacy demonstrated in scores of published studies, injectable agents do carry risks of complications. These procedures require a physician with in-depth knowledge of facial anatomy and injection techniques to ensure patient safety and satisfaction. In general, adverse events are preventable and technique-dependent. Although most adverse events are minor and temporary, more serious complications can occur. The recognition, management, and treatment of poor outcomes are as important as obtaining the best aesthetic results. This review addresses important considerations regarding the complications of injectable neurotoxins and fillers used for "lunch-time" injectable procedures.


Clin Dermatol


Clinics in dermatology


Emer J,Waldorf H




Has Abstract


2011-11-01 00:00:00














  • Experiences with the first eczema school in the United States.

    abstract::Patient education programs are beneficial in the treatment of chronic diseases. In Germany, France, and other countries worldwide, educating children, adolescents, and adults plus the parents of children with atopic dermatitis (AD) leads to better coping with the skin disease, as well as to a reduction in the severity...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Grossman SK,Schut C,Kupfer J,Valdes-Rodriguez R,Gieler U,Yosipovitch G

    更新日期:2018-01-01 00:00:00

  • Occupational acral dermatitis and where the twain shall meet.

    abstract::This contribution, which is somewhat of a departure from the usual format, will focus on dermatologic conditions that are consequences of the patients' choices of employment, hobby, or even other forms of recreation. Most of the cutaneous changes involve the hands and feet, and each is labeled according to the anatomi...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Wolf R,Parish LC,Tüzün Y

    更新日期:2017-01-01 00:00:00

  • Systemic therapies in atopic dermatitis: The pipeline.

    abstract::Atopic dermatitis (AD), the most prevalent inflammatory skin disease, is characterized by robust T-cell activation. The disease has several subtypes, all having a common T helper type 2 (Th2)/Th22 polarization, but it also displays differential immune skewing, such as increased Th17/interleukin 23 skewing in the skin ...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Renert-Yuval Y,Guttman-Yassky E

    更新日期:2017-01-01 00:00:00

  • Feedback practices in dermatology residency programs: building a culture for millennials.

    abstract::Corporate studies have consistently shown that millennials prefer more frequent and detailed feedback in the workplace. With most dermatology residents fitting the description of a millennial, we sought to study their preferences in feedback and then compare this to current feedback practices and cultures. Our study s...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Wang JV,O'Connor M,McGuinn K,Albornoz CA,Keller M

    更新日期:2019-01-01 00:00:00

  • Monitoring biologics for the treatment of psoriasis.

    abstract::Monitoring patients on therapy consists of 2 parts: evaluation of response and mitigation of risk. Biologics for the treatment of psoriasis are no different. Although laboratory assessments are sometimes necessary, the key elements to appropriate monitoring are clinical assessments and vigilant reinforcement of signs ...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Papp KA

    更新日期:2008-09-01 00:00:00

  • Beyond diagnosis and treatment: How simple reassurance makes all the difference.

    abstract::In life there are some people who are confident enought that they do not require reassurance and then there are others that need it constantly just to be able to function in their daily living. I am fortunate enough to experience the gift of reassurance and being able to give it back. As a first time mother, many of t...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Stassiy A

    更新日期:2015-11-01 00:00:00

  • Somatic symptom disorder in dermatology.

    abstract::Somatic symptom disorder (SSD) is defined by the prominence of somatic symptoms associated with abnormal thoughts, feelings, and behaviors related to the symptoms, resulting in significant distress and impairment. Individuals with these disorders are more commonly encountered in primary care and other medical settings...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Levenson JL,Sharma AA,Ortega-Loayza AG

    更新日期:2017-01-01 00:00:00

  • Sentinel lymph node biopsy.

    abstract::The introduction of sentinel lymph node biopsy (SLNB) has been an important development in the management of malignant melanoma. Lymph nodes have long been known to play a key role in melanoma metastasis. The importance of nodal staging accounted for the previous surgical practice of elective lymph node dissection (EL...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Lee KK,Vetto JT,Mehrany K,Swanson NA

    更新日期:2004-05-01 00:00:00

  • Sarcoidosis and malignancy.

    abstract::Malignancy in patients with sarcoidosis occurs in 3 settings. The first setting relates to patients with hematologic malignancies. It includes the sarcoidosis-lymphoma syndrome, which refers to the development of lymphoma at least 1 to 2 years after the diagnosis of sarcoidosis. It also includes patients with sarcoido...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Cohen PR,Kurzrock R

    更新日期:2007-05-01 00:00:00

  • The rash that presents as a red swollen face.

    abstract::A red swollen face can be a skin sign of a potentially life-threatening condition. We present in detail the main clinical presentations, diagnostic tests, and management of some of the most severe conditions that can frequently present as a red and swollen face: acute or recurrent angioedema, mast cell-driven or brady...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Batista M,Gonçalo M

    更新日期:2020-01-01 00:00:00

  • Nutrition and oral mucosal diseases.

    abstract::Oral manifestations of nutritional deficiencies can affect the mucous membranes, teeth, periodontal tissue, salivary glands, and perioral skin. This contribution reviews how the water-soluble vitamins (B(2), B(3), B(6), B(12), C, and folic acid), fat-soluble vitamins (A, D, and E), and minerals (calcium, fluoride, iro...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Thomas DM,Mirowski GW

    更新日期:2010-07-01 00:00:00

  • Antimicrobials in dermatologic surgery: facts and controversies.

    abstract::The two main uses of antimicrobials in dermatologic surgery include prophylaxis for bacteremia and prevention of localized surgical skin infection (LSSI). Bacteremia can result in hematogenous surgical infections such as infective endocarditis and prosthetic joint infection. Comprehensive guidelines from the American ...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Shurman DL,Benedetto AV

    更新日期:2010-09-01 00:00:00

  • LASER-tissue interactions.

    abstract::As new laser devices continue to emerge, it becomes increasingly important for the clinical dermatologist to understand the basic principles behind their operation. A fundamental understanding of how lasers interact with tissue will enable the physician to choose the most appropriate laser for a given clinical situati...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Carroll L,Humphreys TR

    更新日期:2006-01-01 00:00:00

  • Human papillomavirus status in extragenital nonmelanoma skin cancers.

    abstract::About 5% of all cancers worldwide can be attributed to human papillomaviruses (HPVs); namely, six sites are strongly associated with HPV infections: cervix, penis, vulva, vagina, anus, and oropharynx. Nonmelanoma skin cancers (NMSC), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) are the most common mal...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Drvar DL,Lipozenčić J,Sabol I,Mokos ZB,Ilic I,Grce M

    更新日期:2014-03-01 00:00:00

  • Performing research in pregnancy: Challenges and perspectives.

    abstract::There are numerous barriers to conducting clinical research in pregnancy, including ethical considerations, logistical difficulties, and federal regulations. Due to these challenges, there is a paucity of data on the safe and appropriate use of dermatologic therapies in pregnancy, even for easily accessed over-the-cou...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Hartman RI,Kimball AB

    更新日期:2016-05-01 00:00:00

  • The value of screening in melanoma.

    abstract::The incidence of cutaneous melanoma has increased substantially in most white populations during the past several decades. Despite improvements in the early recognition of melanoma and the use of novel diagnostic techniques that enhance our diagnostic capabilities, disease-related mortality remains a significant publi...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Stratigos AJ,Katsambas AD

    更新日期:2009-01-01 00:00:00

  • Cutaneous leishmaniasis.

    abstract::Cutaneous leishmaniasis is a widespread tropical infection caused by numerous different species of Leishmania protozoa that are transmitted by sandflies. Its clinical presentations are extremely diverse and dependent on a variety of parasite and host factors that are poorly understood. Diagnosis should aim to identify...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Bailey MS,Lockwood DN

    更新日期:2007-03-01 00:00:00

  • Treatment of New World cutaneous and mucosal leishmaniases.

    abstract::The most extensive investigations of treatment of New World cutaneous leishmaniasis have been performed against L. panamensis disease in Colombia, and the relative value of regimens shown there may be instructive for disease from other areas. In Colombia, a 90-95% cure rate was achieved with three different drug regim...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Berman JD

    更新日期:1996-09-01 00:00:00

  • Psoriasis: Psychosomatic, somatopsychic, or both?

    abstract::Psoriasis is a chronic inflammatory disorder characterized by substantial psychiatric comorbidity. Historically, anecdotal observations have suggested that psychosocial distress can trigger flares of psoriasis, but over the past several decades, high-quality data from experimental studies support the assertion that st...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Kwon CW,Fried RG,Nousari Y,Ritchlin C,Tausk F

    更新日期:2018-01-01 00:00:00

  • Phototherapy for atopic dermatitis.

    abstract::Phototherapy is a second-line treatment for moderate to severe atopic dermatitis (AD) that effectively decreases cutaneous inflammation with minimal or no systemic side effects. Children in grade school, adolescents, and adults may benefit from phototherapy, when they have chronic AD refractory to first-line topical t...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Rodenbeck DL,Silverberg JI,Silverberg NB

    更新日期:2016-09-01 00:00:00

  • Psychologic consequences of facial dermatoses.

    abstract::The attractiveness of the human body has always been an important issue in the fields of sociology, psychology, and psychiatry and also in the field of dermatology. In psychodermatology, one often discovers how all these fields intermingle to produce elaborate situations and extreme human difficulties. Perfect skin is...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Orion E,Wolf R

    更新日期:2014-11-01 00:00:00

  • Genetic disorders of pigmentation.

    abstract::More than 127 loci are actually known to affect pigmentation in mouse when they are mutated. From embryogenesis to transfer of melanin to the keratinocytes or melanocytes survival, any defect is able to alter the pigmentation process. Many gene mutations are now described, but the function of their product protein and...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Passeron T,Mantoux F,Ortonne JP

    更新日期:2005-01-01 00:00:00

  • Intrahepatic cholestasis of pregnancy: Recent advances.

    abstract::Intrahepatic cholestasis of pregnancy, also known as obstetric cholestasis, is a pruritic condition of pregnancy characterized by an underlying elevation in circulating bile acids and liver derangement, and associated with adverse fetal outcomes, such as preterm labor and stillbirth. Limited understanding of the under...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Ovadia C,Williamson C

    更新日期:2016-05-01 00:00:00

  • The modern paradigm of phototherapy.

    abstract::The recognition of medical benefits obtained with suberythemogenic doses of natural sunlight extends back centuries. Modern medical application of phototherapy has been in place for over 100 years. It is the nature of scientific discovery to depend upon the use of new investigational methods or new devices to gain a b...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Zanolli M

    更新日期:2003-09-01 00:00:00

  • Why we should let "evidence-based medicine" rest in peace.

    abstract::Evidence-based medicine is a redundant term to the extent that doctors have always claimed they practiced medicine on the basis of evidence. They have, however, disagreed about what exactly constitutes legitimate evidence and how to synthesize the totality of evidence in a way that supports clinical action. Despite cl...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Rees J

    更新日期:2013-11-01 00:00:00

  • Dermatology resident perspectives on practice ownership structures and private equity-backed group practices.

    abstract::Recently, dermatology group practice ownership structures have changed, as private equity (PE) consolidates independent dermatology practices to create larger groups. Currently, little is known about how dermatology residents perceive practice ownership structures, including those that are owned by PE. One hundred thi...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Novice T,Portney D,Eshaq M

    更新日期:2020-01-01 00:00:00

  • Cutaneous zygomycosis.

    abstract::Cutaneous zygomycosis is a fungal infection caused by zygomycetes that affects the skin. It occurs in uncontrolled diabetic patients and immunosuppressed individuals. It has 2 clinical forms: primary cutaneous zygomycosis and secondary cutaneous zygomycosis. The first is characterized by necrotic lesions and the fungu...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Bonifaz A,Vázquez-González D,Tirado-Sánchez A,Ponce-Olivera RM

    更新日期:2012-07-01 00:00:00

  • Morphologic grading and treatment of facial actinic keratosis.

    abstract::Actinic keratoses (AKs) represent the earliest stage in the development of squamous cell carcinoma (SCC) and represent important biomarkers for individuals at risk for development of invasive SCC. Based on clinical morphology, AK can be subdivided into three different grades, which correspond to specific dermatoscopic...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Zalaudek I,Piana S,Moscarella E,Longo C,Zendri E,Castagnetti F,Pellacani G,Lallas A,Argenziano G

    更新日期:2014-01-01 00:00:00

  • Isomorphic phenomenon of Koebner: facts and controversies.

    abstract::Heinrich Koebner (1838-1904) presented in a meeting in 1872 and reported in 1877 the emergence of psoriatic lesions following trauma to healthy skin areas of patients with psoriasis. Since then, the Koebner phenomenon has been the subject of research, as it offers a unique opportunity in the investigation of the disea...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章


    authors: Camargo CM,Brotas AM,Ramos-e-Silva M,Carneiro S

    更新日期:2013-11-01 00:00:00

  • Connective tissue diseases: pseudoxanthoma elasticum, anetoderma, and Ehlers-Danlos syndrome in pregnancy.

    abstract::The relationship between pregnancy and diseases of the elastic fibers, such as pseudoxanthoma elasticum, cutis laxa, and anetoderma, is discussed in this article. Dermatologists and other physicians must be aware that these problems may be present in pregnant women and must also know how to counsel those who suffer fr...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审


    authors: Ramos-E-Silva M,Líbia Cardozo Pereira A,Bastos Oliveira G,Coelho da Silva Carneiro S

    更新日期:2006-03-01 00:00:00