Injectable neurotoxins and fillers: there is no free lunch.

Abstract:

: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.

journal_name

Clin Dermatol

journal_title

Clinics in dermatology

authors

Emer J,Waldorf H

doi

10.1016/j.clindermatol.2011.08.005

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

678-90

issue

6

eissn

0738-081X

issn

1879-1131

pii

S0738-081X(11)00209-4

journal_volume

29

pub_type

杂志文章,评审
  • No more pens: what the 2009 Pharmaceutical Research and Manufacturer's Association code changes really mean.

    abstract::In 2002, new guidelines for interactions with the pharmaceutical industry and physicians were published as an official code of conduct. Adherence to the guidelines was voluntary, and there were no provisions for discipline to companies who did not subscribe to the code or who subscribed but did not comply. Many of the...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章

    doi:10.1016/j.clindermatol.2009.02.005

    authors: Meffert JJ

    更新日期:2009-07-01 00:00:00

  • Mal de Meleda: A great imitator.

    abstract::Mal de Meleda is an hereditary palmoplantar keratoderma named for the Mljet Island in Croatia. The lives of those affected by this disease represent a complex situation that encompasses members of a vulnerable group. They require enlightenment and should be approached with awareness, taking into account their overall ...

    journal_title:Clinics in dermatology

    pub_type: 历史文章,杂志文章,评审

    doi:10.1016/j.clindermatol.2019.01.003

    authors: Bakija-Konsuo A,Zitinski M,Fatovic-Ferencic S

    更新日期:2019-01-01 00:00:00

  • Melanocytes, melanocyte stem cells, and melanoma stem cells.

    abstract::Melanocyte stem cells differ greatly from melanoma stem cells; the former provide pigmented cells during normal tissue homeostasis and repair, and the latter play an active role in a lethal form of cancer. These 2 cell types share several features and can be studied by similar methods. Aspects held in common by both m...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2012.08.014

    authors: Lang D,Mascarenhas JB,Shea CR

    更新日期:2013-03-01 00:00:00

  • The path to modernity: a personal testimony to the restructuring of the Department of Dermatology, Vargas Hospital, Caracas, Venezuela.

    abstract::In the late 1950s and early1960s, there was a concerted effort to modernize teaching, training, and patient care in the Vargas Hospital of Caracas, Venezuela. The above included the development of research in the frame of postgraduate training. This effort was to be helped by USA funds and institutions but could only ...

    journal_title:Clinics in dermatology

    pub_type: 历史文章,杂志文章

    doi:10.1016/j.clindermatol.2013.08.017

    authors: Kerdel-Vegas F

    更新日期:2014-03-01 00:00:00

  • Personality disorders and the "difficult" dermatology patient: Maximizing patient satisfaction.

    abstract::Personality disorders (PDs) are stable and enduring patterns of thought, feeling, and behavior that deviate from one's cultural norms and cause impairment in functionality. Patients with PDs are commonly encountered in the dermatologic setting and can be perceived by providers as "difficult." Given that PDs are chroni...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章

    doi:10.1016/j.clindermatol.2017.01.009

    authors: Nakamura M,Koo J

    更新日期:2017-01-01 00:00:00

  • Skin aging: the dermal perspective.

    abstract::The world population of adults aged 60 years or more is increasing globally, and this development can impact skin disease morbidity and mortality, as well as being reflected in the health care system organization. There is substantial evidence that the burden from a remarkable number of skin nonmalignant and malignant...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章

    doi:10.1016/j.clindermatol.2019.04.005

    authors: Strnadova K,Sandera V,Dvorankova B,Kodet O,Duskova M,Smetana K,Lacina L

    更新日期:2019-01-01 00:00:00

  • Global epidemiology of cutaneous zygomycosis.

    abstract::The large majority of cases reported worldwide as zygomycosis are infections caused by fungi belonging to the order Mucorales. These infections are invasive, often lethal, and they primarily affect immunocompromised patients. Cutaneous zygomycosis is the third most common clinical presentation, after sinusitis and pul...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2012.01.010

    authors: Skiada A,Rigopoulos D,Larios G,Petrikkos G,Katsambas A

    更新日期:2012-11-01 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

    doi:10.1016/j.clindermatol.2007.03.010

    authors: Cohen PR,Kurzrock R

    更新日期:2007-05-01 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

    doi:10.1016/j.clindermatol.2010.03.025

    authors: Thomas DM,Mirowski GW

    更新日期:2010-07-01 00:00:00

  • Obsession with perfection: Body dysmorphia.

    abstract::The deeply rooted fascination with beauty penetrates society worldwide. The indulgence to look and feel beautiful pervades all ages, genders, and nationalities, with research conferring a remarkable tendency to agree on measures of attractiveness among these disparate groups. Research has found that beautiful people d...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章

    doi:10.1016/j.clindermatol.2016.04.006

    authors: Vashi NA

    更新日期:2016-01-01 00:00:00

  • The historical basis of a misconception leading to undertreating atopic dermatitis (eczema): facts and controversies.

    abstract::The quest for clarifying the pathophysiology of atopic dermatitis (eczema) has lasted for 25 centuries. Yearning to discern the primum movens of atopic dermatitis, physicians aimed to identify the curative therapy. Recent scientific efforts has brought to the light an ever-growing amount of interplaying pathophysiolog...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2009.03.009

    authors: Farhi D,Taïeb A,Tilles G,Wallach D

    更新日期:2010-01-01 00:00:00

  • Acne: Kids are not just little people.

    abstract::Acne vulgaris is a common inflammatory disease of the pilosebaceous follicles that affects patients of all ages, from neonates to adults. We have compared and contrasted the clinical presentation of acne in neonates, infants, children, teenagers, and young adults and review the scenarios in which further systemic endo...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2016.07.005

    authors: Que SKT,Whitaker-Worth DL,Chang MW

    更新日期:2016-01-01 00:00:00

  • Obesity and dermatology.

    abstract::Obesity is associated with a number of dermatoses. It affects cutaneous sensation, temperature regulation, foot shape, and vasculature. Acanthosis nigricans is the most common dermatological manifestation of obesity. Skin tags are more commonly associated with diabetes than with obesity. Obesity increases the incidenc...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2004.01.001

    authors: Scheinfeld NS

    更新日期:2004-07-01 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

    doi:10.1016/j.clindermatol.2018.08.009

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

    更新日期:2018-01-01 00:00:00

  • Life-threatening mycobacteria infection.

    abstract::Most mycobacteria cause localized and often harmless infections of the skin. Leprosy, which dates back to approximately 60 bc in India, was supposed to be eliminated as a public health problem by the year 2000. With a new case detection rate between 600,000 and 700,000 yearly however, leprosy, with its sometimes devas...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2004.06.006

    authors: Faber WR

    更新日期:2005-05-01 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

    doi:10.1016/j.clindermatol.2005.10.019

    authors: Carroll L,Humphreys TR

    更新日期:2006-01-01 00:00:00

  • Noncosmetic uses of botulinum toxin.

    abstract::Since the introduction of botulinum toxin (BTX) as a therapeutic tool in the 1970s, the number of uses for this substance has increased exponentially. BTX's mechanism of action involves degrading the SNARE proteins blockading the release of acetylcholine into the neuromuscular junction. In many body systems, decrease ...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2003.12.030

    authors: Bentsianov B,Zalvan C,Blitzer A

    更新日期:2004-01-01 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

    doi:10.1016/j.clindermatol.2015.10.002

    authors: Stassiy A

    更新日期:2015-11-01 00:00:00

  • Miscellaneous skin disease and the metabolic syndrome.

    abstract::The link between the metabolic syndrome (MetS) and skin diseases is increasingly important, with new associations being discovered. The association between MetS and psoriasis or MetS and hidradenitis suppurativa is well known, although the relationship between MetS and various autoimmune or inflammatory diseases has o...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2017.09.016

    authors: Seremet S,Gurel MS

    更新日期:2018-01-01 00:00:00

  • Perfluoropolyether phosphate: a non-irritating acidic agent of cosmeceutical use.

    abstract::Formulating at acidic pH is a route to improve the chemical or biological stability and the performances of cosmeceuticals. Unfortunately, its potential is limited by the poor differentiation of available acidic agents, and by the risk of skin irritation. Recently, a perfluoropolyether phosphate was proposed to formul...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2008.04.005

    authors: Pantini G

    更新日期:2008-07-01 00:00:00

  • Commercial preparations and handling of botulinum toxin type A and type B.

    abstract::The recognition of botulinum toxin as a therapeutic tool has revolutionized the approach to facial esthetics. In the 1970s, Dr. Alan B. Scott pioneered the use of botulinum toxin type A (BTX-A) for strabismus. This discovery led to further studies examining other clinical applications of BTX-A and, more recently, botu...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2003.11.009

    authors: Parish JL

    更新日期:2003-11-01 00:00:00

  • Metastatic melanoma in the older patient: special considerations.

    abstract::Cancer is a disease of older age where genomic instability, impaired DNA repair, and weakened immune surveillance against cancer are recognized to play a causative role. Because the incidence of melanoma is increasing at a very fast pace in the elderly and there is a rapid expansion of the aging population, a large nu...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2012.08.011

    authors: Hegde UP,Grant-Kels JM

    更新日期:2013-05-01 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

    doi:10.1016/j.clindermatol.2016.09.002

    authors: Wolf R,Parish LC,Tüzün Y

    更新日期:2017-01-01 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

    doi:10.1016/j.clindermatol.2013.08.009

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

    更新日期:2014-03-01 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

    doi:10.1016/j.clindermatol.2016.02.004

    authors: Ovadia C,Williamson C

    更新日期:2016-05-01 00:00:00

  • Treatment of alopecia areata with squaric acid dibutylester.

    abstract::Squaric acid dibutylester is a topical sensitizing agent utilized for the treatment of alopecia areata. The mechanism of action is not fully understood, but is believed to redirect the inflammatory response by invoking allergic contact dermatitis. Several studies have compared the efficacy of squaric acid dibutylester...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2014.12.001

    authors: Hill ND,Bunata K,Hebert AA

    更新日期:2015-05-01 00:00:00

  • Variations in pain perception during the menstrual cycle: implications for esthetic procedures.

    abstract::Variations in pain perception have long been studied in the medical literature, especially for women in regards to their menstrual cycle. Anecdotally, women can be more sensitive to painful stimuli from cosmetic procedures during their menses; however, no studies have thoroughly examined variations in pain perception ...

    journal_title:Clinics in dermatology

    pub_type: 杂志文章,评审

    doi:10.1016/j.clindermatol.2019.10.011

    authors: Wang JV,Hattier G,Jhawar N,Mesinkovska N,Zachary CB,Saedi N

    更新日期:2019-01-01 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

    doi:10.1016/j.clindermatol.2003.12.011

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

    更新日期:2004-05-01 00:00:00

  • Robert Koch (1843-1910) and dermatology on his 171st birthday.

    abstract::Robert Koch (1843-1910) received the Nobel Prize in Medicine in 1905 for his studies of tuberculosis. He contributed significantly to microbiology, isolating also cholera and anthrax pathogens, and introducing several postulates in this field. In addition, he developed staining methods, as well as culturing and micros...

    journal_title:Clinics in dermatology

    pub_type: 传,历史文章,杂志文章

    doi:10.1016/j.clindermatol.2013.10.005

    authors: Grzybowski A,Pietrzak K

    更新日期:2014-05-01 00:00:00

  • Robert Remak (1815-1865): discoverer of the fungal character of dermatophytoses.

    abstract::Robert Remak was the first scientist to undertake successful research on fungal skin infections. A neurologist, physiologist, and embryologist, Remak was the first to observe the fungal changes causing the disease of favus; however, he gave credit for the discovery to Professor Johann Schönlein and denied all attempts...

    journal_title:Clinics in dermatology

    pub_type: 传,历史文章,杂志文章

    doi:10.1016/j.clindermatol.2012.11.002

    authors: Grzybowski A,Pietrzak K

    更新日期:2013-11-01 00:00:00