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Cox SE, Kaufman-Janette J, Cohen JL, Gold M, Joseph J, Nestor MS, Rzany B, Taylor S, Zhou J, Cecerle M, Pueraro E, Irvine R, Dayan S. LetibotulinumtoxinA Attenuates the Psychological Burden of Glabellar Lines and Is Associated With High Subject Satisfaction in Phase 3 Clinical Trials. Dermatol Surg 2024; 50:535-541. [PMID: 38470985 DOI: 10.1097/dss.0000000000004152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Hyperfunctional glabellar frown lines can transmit facial miscues that adversely affect emotional communication, increase perceptions of age, and diminish self-esteem. OBJECTIVE To evaluate the efficacy of letibotulinumtoxinA in mitigating the negative psychological impact associated with moderate to severe glabellar lines and to assess subject satisfaction with treatment outcome in the BLESS phase 3 clinical trials. MATERIALS AND METHODS Baseline and posttreatment assessments were made using validated subject-administered instruments: Modified Skindex-16 Glabellar Line Quality of Life (GL-QoL) Scale, Facial Assessment and Cosmetic Evaluation Questionnaire (FACE-Q) Appraisal of Lines Between Eyebrows Scale, FACE-Q Age Appraisal Visual Analog Scale, and FACE-Q Satisfaction with Outcome Scale. An integrated analysis using pooled BLESS data was conducted on these secondary end points. RESULTS Among enrolled and treated subjects ( N = 1,272), 85.5% had moderate to severe psychological impact at baseline. LetibotulinumtoxinA subjects experienced significant improvements compared with placebo on all measures. Mean improvement to Week 4 for the Modified Skindex-16 GL-QoL Scale overall score was -33.84 for letibotulinumtoxinA subjects compared with -1.37 for placebo subjects ( p < .001). Attenuation of psychological burden was highly correlated with improvement in glabellar line severity ( p < .0001). CONCLUSION LetibotulinumtoxinA significantly improved the psychosocial burden associated with glabellar lines across all trials. Treated subjects experienced improved quality of life, younger perceived age, and satisfaction with treatment outcome.
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Affiliation(s)
| | | | - Joel L Cohen
- AboutSkin Dermatology and DermSurgery, Greenwood Village, Colorado
| | - Michael Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee
| | - John Joseph
- Clinical Testing of Beverly Hills, Beverly Hills, California
| | - Mark S Nestor
- Center for Clinical and Cosmetic Research, Aventura, Florida
- Division of Plastic Surgery, Department of Dermatology and Cutaneous Surgery and the Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Berthold Rzany
- Private Practice, Berlin, Germany . Dr. Rzany now with the Medizin am Hauptbahnhof, Vienna, Austria
| | - Susan Taylor
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jihao Zhou
- JZ Consulting, Orange County, California
| | | | | | - Ryan Irvine
- Hugel America, Inc., Newport Beach, California
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Di Rosa L, De Pasquale A, Baldassano S, Marguglio N, Drid P, Proia P, Vasto S. New Regenerative and Anti-Aging Medicine Approach Based on Single-Stranded Alpha-1 Collagen for Neo-Collagenesis Induction: Clinical and Instrumental Experience of a New Injective Polycomponent Formulation for Dermal Regeneration. Biomedicines 2024; 12:916. [PMID: 38672270 PMCID: PMC11048055 DOI: 10.3390/biomedicines12040916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
This study explores the efficacy of a novel polycomponent formulation (KARISMA Rh Collagen® FACE, Taumedika Srl, Rome, Italy), containing 200 mg/mL of non-crosslinked high-molecular-weight hyaluronic acid (HMW-HA), 200 μg/mL of a human recombinant polypeptide of collagen-1 alpha chain, and 40 mg/mL of carboxymethyl cellulose (CMC) as a regenerative medicine for skin regeneration and rejuvenation. This formulation combines non-crosslinked high-molecular-weight hyaluronic acid, human recombinant polypeptide of collagen-1 alpha chain, and carboxymethyl cellulose to stimulate collagen type I production and enhance skin hydration. This study involved 100 subjects with varying skin conditions, divided into three groups based on skin aging, smoking history, and facial scarring, to evaluate the product's effectiveness in skin regeneration and aesthetic improvement. The methodology included two injections of Karisma (2 mL for each injection) one month apart, with evaluations conducted using FACE-Q questionnaires, the SGAIS Questionnaire, and Antera 3D skin scanner measurements at baseline, 30 days, and 60 days post-treatment. The results demonstrated a significant reduction in skin roughness and an improvement in skin quality across all the groups, with no correlation between the outcomes and the patient's age. The subjective assessments also indicated high satisfaction with the treatment's aesthetic results. The analyzed data allow us to conclude that the single-stranded collagen with hyaluronic acid and carboxymethyl-cellulose formulation is able to stimulate the skin's regenerative response, yielding significant results both in vitro and, through our study, also in vivo. This new polycomponent formulation effectively stimulates skin regeneration, improving skin quality and texture, with significant aesthetic benefits perceived by patients, and a low incidence of adverse events, marking a promising advancement in regenerative medicine.
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Affiliation(s)
- Luigi Di Rosa
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy; (S.B.); (N.M.); (S.V.)
| | | | - Sara Baldassano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy; (S.B.); (N.M.); (S.V.)
| | - Noemi Marguglio
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy; (S.B.); (N.M.); (S.V.)
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Patrizia Proia
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, 90100 Palermo, Italy;
| | - Sonya Vasto
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90100 Palermo, Italy; (S.B.); (N.M.); (S.V.)
- Euro-Mediterranean Institutes of Science and Technology (IEMEST), 90139 Palermo, Italy
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Klassen AF, Pusic AL, Kaur M, Rae C, Poulsen L, Mansouri J, Tsangaris E, Dayan S, Klok J, Armstrong K, Santosa K, Cano S. Extending the Range of Measurement for Minimally Invasive Treatments by Adding New Concepts to FACE-Q Aesthetics Scales. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5736. [PMID: 38600967 PMCID: PMC11005895 DOI: 10.1097/gox.0000000000005736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/28/2024] [Indexed: 04/12/2024]
Abstract
Background The Satisfaction with Face Overall and Psychological Function scales are the most frequently used FACE-Q Aesthetics module scales. This study aimed to extend their range of measurement by adding and testing new concepts. We aimed to create FACE-Q Aesthetics item libraries. Methods In-depth concept elicitation interviews were conducted. Concepts were formed into items and refined through multiple rounds of patient and expert input. The items were tested with people living in the United States, Canada, and the United Kingdom who had minimally invasive facial aesthetic treatments. Participants were recruited through an online platform (ie, Prolific). Psychometric properties were examined using Rasch measurement theory analysis, test-retest reliability, and construct validity. Results We conducted 26 interviews. New concepts were developed into items and refined with input from 12 experts, 11 clinic patients, and 184 Prolific participants. A sample of 1369 Prolific participants completed 52 appearance and 22 psychological items. After removing 10 and 2 items respectively, the psychometric tests provided evidence of reliability with the person separation index, Cronbach alpha, and test-retest reliability values without extremes of 0.88 or more. For validity, lower scores were associated with looking older than one's age, being more bothered by facial skin laxity, treatment wearing off, and having deeper lines on Merz Assessment scales. Short-form scales formed from the 42 appearance items provide examples of item library application. Conclusions This study provides an innovative means to customize scales to measure appearance and psychological function that maximizes content validity and minimizes respondent burden in the context of minimally invasive treatments.
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Affiliation(s)
| | - Andrea L Pusic
- Patient Reported Outcome, Value, and Experience (PROVE) Center, Department of Surgery, Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, Mass
| | - Manraj Kaur
- Patient Reported Outcome, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Mass
| | - Charlene Rae
- From McMaster University, Hamilton, Ontario, Canada
| | - Lotte Poulsen
- Research Unit for Plastic Surgery, University of Southern Denmark, Odense, Denmark
| | - Jasmine Mansouri
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Elena Tsangaris
- Patient Reported Outcome, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, Boston, Mass
| | | | - Jennifer Klok
- Dr. Jennifer Klok clinic, West Vancouver, British Columbia, Canada
| | | | | | - Stefan Cano
- Modus Outcomes (a company of Thread), Cheltenham, United Kingdom
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Klassen AF, Pusic AL, Kaur M, Mansouri J, Tsangaris E, Dayan S, Klok J, Armstrong K, Santosa K, Rae C, Poulsen L, Cano SJ. The SKIN-Q: An Innovative Patient-Reported Outcome Measure for Evaluating Minimally Invasive Skin Treatments for the Face and Body. Facial Plast Surg Aesthet Med 2024. [PMID: 38466952 DOI: 10.1089/fpsam.2023.0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Background: As the aesthetics field continues to innovate, it is important that outcomes are carefully evaluated. Objectives: To develop item libraries to measure how skin looks and feels from the patient perspective, that is, SKIN-Q. Methods: Concept elicitation interviews were conducted and data were used to draft the SKIN-Q, which was refined with patient and expert feedback. An online sample (i.e., Prolific) provided field-test data. Results: We conducted 26 qualitative interviews (88% women; 65% ≥ 40 years of age). A draft of the SKIN-Q item libraries were formed and revised with input from 12 experts, 11 patients, and 174 online participants who provided 180 survey responses. The psychometric sample of 657 participants (82% women; 36% aged ≥40 years) provided 713 completed surveys (facial, n = 595; body, n = 118). After removing 14 items, the psychometric analysis provided evidence of reliability (≥0.85) and validity for a 20-item set that measures how skin feels and a 46-item set that measures how skin looks. Short-form scales were tested to provide examples for how to utilize the item sets. Conclusion: The SKIN-Q represents an innovative way to measure satisfaction with skin (face and body) in the context of minimally invasive treatments.
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Affiliation(s)
- Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Andrea L Pusic
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Manraj Kaur
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jasmine Mansouri
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Elena Tsangaris
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Steven Dayan
- Dayan Facial Plastic Surgery, Chicago, Illinois, USA
| | | | | | - Katherine Santosa
- The Center for Plastic Surgery at MetroDerm, Alpharetta, Georgia, USA
| | - Charlene Rae
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Lotte Poulsen
- Research Unit for Plastic Surgery, Odense University Hospital, Løntoft, Nyhøj and Poulsen Plastic Surgery, Odense, Denmark
| | - Stefan J Cano
- Modus Outcomes (a Division of Thread), Cheltenham, United Kingdom
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Morhy ON, Sisnando AL, Câmara-Souza MB, Carbone AC, De la Torre Canales G. High Levels of Physical Activity Reduce the Esthetic Durability of Botulinum Toxin Type A: A Controlled Single-Blind Clinical Trial. Toxins (Basel) 2023; 15:463. [PMID: 37505732 PMCID: PMC10467136 DOI: 10.3390/toxins15070463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
The present study aimed to evaluate the influence of physical activity on the durability of the esthetic effect of botulinum toxin type A (BoNT-A). Sixty female patients were allocated to three groups (n = 20) according to their physical activity level (PA): Low PA, Moderate PA, and High PA. All groups received a single injection of onabotulinumtoxinA, considering standardized doses in the frontalis (12U), corrugator supercilia (7U, each), and procerus muscles (4U). Outcomes were measured using electromyography (EMG), Merz 5-point scales, and Face-Q scales (perceived age and lines between eyebrows). A follow-up occurred after 30, 60, and 90 days. EMG results showed a significant decrease in muscle activity in the Low-PA group at all follow-ups compared with the other groups (p < 0.001). The Merz scale scores showed that the severity of forehead and glabellar lines significantly improved in the Low-PA group throughout this study compared with the other groups (p < 0.001). No significant differences between groups were found in the Face-Q scale for perceived age, while the Face-Q scale for lines between eyebrows showed better results for Low-PA (p < 0.01) and Moderate-PA (p < 0.01) groups compared to the High-PA group at the 30- and 90-day follow-ups. The durability of the esthetic effect of BoNT-A seems to be negatively influenced by the level of physical activity.
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Affiliation(s)
- Omar Neves Morhy
- Ingá University Center, Department of Dentistry, Uningá, Paraná 87035-510, Brazil; (O.N.M.); (A.L.S.); (M.B.C.-S.); (A.C.C.)
| | - Andréa Lisbôa Sisnando
- Ingá University Center, Department of Dentistry, Uningá, Paraná 87035-510, Brazil; (O.N.M.); (A.L.S.); (M.B.C.-S.); (A.C.C.)
| | - Mariana Barbosa Câmara-Souza
- Ingá University Center, Department of Dentistry, Uningá, Paraná 87035-510, Brazil; (O.N.M.); (A.L.S.); (M.B.C.-S.); (A.C.C.)
| | - Ana Claudia Carbone
- Ingá University Center, Department of Dentistry, Uningá, Paraná 87035-510, Brazil; (O.N.M.); (A.L.S.); (M.B.C.-S.); (A.C.C.)
| | - Giancarlo De la Torre Canales
- Ingá University Center, Department of Dentistry, Uningá, Paraná 87035-510, Brazil; (O.N.M.); (A.L.S.); (M.B.C.-S.); (A.C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Caparica, Portugal
- Department of Dental Medicine, Karolinska Institutet, Scandinavian Network for Orofacial Neurosciences (SCON), 141-52 Huddinge, Sweden
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Zhang D, Zhao F, Du L, Jin X. Soft and Hard Tissue Changes and Facial Rejuvenation of Anterior Maxillary Segmental Osteotomy: A Three-Dimensional Cephalometric Study. Aesthetic Plast Surg 2023; 47:271-281. [PMID: 36002775 DOI: 10.1007/s00266-022-03063-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore the efficacy of anterior maxillary segmental osteotomy (AMSO) in reliving maxillary protrusion and better analyze the three-dimensional (3D) morphological changes of the postoperative nasolabial region using computed tomography (CT) and evaluate the trend of facial rejuvenation. MATERIALS AND METHODS Forty-five patients who underwent AMSO from January 2017 to December 2021 were retrospectively included. CT and oriented photography were performed before and 10 months after the treatment. The mimics17.0 software was used to reconstruct the 3D CT scan results before and after the operation, measure the data of each anatomical index, and systematically evaluate the soft tissue changes in the nasolabial region. The patients themselves, the plastic surgeons, family members, or friends of patients use the Face-Q Age Appraisal Visual Analogue Scale (VAS) to evaluate the changes in patients' visual age before and after the operation. RESULTS Forty-five cases of maxillary protrusion were alleviated. Seen from the side, the protruding degree of the upper lip is obviously reduced. In the front view, ∠Cont-Sbal-F, the width of alar base, and alae nasi all increased significantly. Contrary to traditional perceptions, the protrusion and height of the nose tip actually increased rather than decreased after AMSO. The visual age score improved positively, and patients obtained facial rejuvenation. No serious complications occurred; after 10-month follow-up, we achieved a high degree of satisfaction. CONCLUSION AMSO can significantly improve the maxillary protrusion, and it can increase the protrusion and height of the nose tip. Also, patients can get a younger appearance. Comprehensive preoperative evaluation and postoperative nasolabial morphology with maxillary protrusion patients are helpful for correct clinical decision-making. At the same time, the operation suggests a new choice of facial rejuvenation for patients with maxillary protrusion. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Dong Zhang
- 16th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Fangning Zhao
- 16th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Le Du
- 16th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Xiaolei Jin
- 16th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
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Traditional versus Laterally Extended Upper Blepharoplasty Skin Excisions: Objective and Patient-Reported Outcomes. Plast Reconstr Surg 2023; 151:73-82. [PMID: 36205656 DOI: 10.1097/prs.0000000000009801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Different skin excision shapes may result in different aesthetic outcomes after upper blepharoplasty. METHODS Two skin-only excision shapes were evaluated objectively and subjectively in 28 matched patients with laterally extended skin excision (group A) or traditional elliptical skin excision (group B). The pretarsal show, lateral eyebrow height, amount of scarring (evaluated with the Patient and Observer Scar Assessment Scale), and patient-reported aesthetic results (evaluated using FACE-Q) were scored and compared at 6 and 12 months postoperatively. RESULTS In both groups, pretarsal show improved significantly after blepharoplasty. The homogeneity of pretarsal show improved significantly in the lateral extension group (group A) together with slightly more pretarsal show (0.5 to 0.8 mm at central pupil region) at 6 and 12 months of follow-up compared with group B ( P = 0.004). A trend was observed in the exocanthion 45-degree measurement, in which group A had 0.6 mm greater pretarsal show 6 months postoperatively. Homogeneity of the pretarsal show had improved significantly in group A, but not in group B, at 12 months after blepharoplasty. No other significant differences were observed between the groups regarding pretarsal show measurements or FACE-Q scores. Both groups showed descent of the lateral eyebrow, but this was only significant in group B. Group B showed 1.4 to 2.0 mm more descent compared with group A. Scarring and adverse effects scores were low in both groups and did not differ. CONCLUSION Laterally extended skin excision and traditional elliptical skin excision both result in positive aesthetic results, but the laterally extended skin excision technique is accompanied by a slightly more favorable outcome. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
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The Face- and Neck-Lift Objective Photo-Numerical Assessment Scale: A Complete Scale for Face-Lift Evaluation. Plast Reconstr Surg 2023; 151:64-71. [PMID: 36205657 DOI: 10.1097/prs.0000000000009797] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Success or failure of plastic surgery procedures relies on cosmetic results. Understanding the objective perception of favorable aesthetic results is critical to ensure patient satisfaction. The aim of this study was to develop and validate a new facial rating scale that could objectively assess face- and neck-lift outcomes: the Face- and Neck-Lift Objective Photo-Numerical Assessment Scale. METHODS One thousand White patients were included in the authors' study and assessed. To validate the authors' scale, the interrater reliability and the test-retest reliability were analyzed. The Rasch model was used as part of the scale validation process. RESULTS Eleven scales for face- and neck-lift outcomes assessment were developed. All scales exceeded criteria for acceptability, reliability, and validity. The interrater and intrarater reliabilities were good, with a substantial or virtually perfect interrater reliability for the total score ( P = 0.15). CONCLUSIONS The authors' results allowed us to validate the Face- and Neck-Lift Objective Photo-Numerical Assessment Scale as a reliable and reproducible tool to assess face- and neck-lift outcomes. This scale could be also considered as an important new metric to be used in facial rejuvenation surgery clinical research.
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Naughton GK, Jiang LI, Makino ET, Chung R, Nguyen A, Cheng T, Kadoya K, Mehta RC. Targeting Multiple Hallmarks of Skin Aging: Preclinical and Clinical Efficacy of a Novel Growth Factor-Based Skin Care Serum. Dermatol Ther (Heidelb) 2022; 13:169-186. [PMID: 36374431 PMCID: PMC9823186 DOI: 10.1007/s13555-022-00839-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The aging process involves numerous biological mechanisms that have been characterized and proposed as the "hallmarks of aging." Targeting the processes and pathways related to these hallmarks of aging that cause and promote skin aging could provide anti-aging benefits. A novel topical growth factor-based skin care serum (A+) was developed using human fibroblast conditioned media. This study aimed to assess the effects of A+ on four hallmarks of aging and its clinical efficacy in skin rejuvenation in subjects with moderate to severe overall facial photodamage. METHODS Preclinical studies included immunohistochemistry in human ex vivo skin, and gene expression analysis in human 3D skin models. A 24-week, vehicle placebo-controlled study, including FaceQ patient-reported outcomes and skin biopsy analysis, was performed to assess clinical efficacy and tolerability. RESULTS Treatment with A+ resulted in reduced expression of cell senescence biomarker H2A.J and upregulation of genes associated with proteasome, autophagy, stemness, and intercellular communication. Clinical assessments showed A+ provided significantly greater reductions in sagging, coarse lines/wrinkles, fine lines/wrinkles, overall photodamage, and overall hyperpigmentation compared with placebo. Subjects felt they appeared younger-looking, reporting a median decrease in self-perceived age of 6 years after 12 weeks of use. Decreased levels of H2A.J and increased expression of key dermal extracellular matrix and epidermal barrier components, including collagen and elastin, were observed in skin biopsy samples. CONCLUSION The present study shows for the first time the potential effects of a topical growth factor-based cosmeceutical on cellular processes related to four hallmarks of aging (cellular senescence, loss of proteostasis, stem cell exhaustion, and altered intercellular communication) to help delay the aging process and restore aged skin. A+ targets the biological mechanisms underlying the aging process itself and stimulates skin regeneration, resulting in rapid and significant clinical improvements.
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Affiliation(s)
| | | | - Elizabeth T Makino
- Allergan Aesthetics, an AbbVie company, 2525 Dupont Drive, Irvine, CA, 92612, USA
| | - Robin Chung
- Allergan Aesthetics, an AbbVie company, 2525 Dupont Drive, Irvine, CA, 92612, USA
| | - Audrey Nguyen
- Allergan Aesthetics, an AbbVie company, 2525 Dupont Drive, Irvine, CA, 92612, USA
| | - Tsing Cheng
- Allergan Aesthetics, an AbbVie company, 2525 Dupont Drive, Irvine, CA, 92612, USA
| | - Kuniko Kadoya
- Allergan Aesthetics, an AbbVie company, 2525 Dupont Drive, Irvine, CA, 92612, USA
| | - Rahul C Mehta
- Allergan Aesthetics, an AbbVie company, 2525 Dupont Drive, Irvine, CA, 92612, USA.
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Volumetric Effect and Patient Satisfaction after Facial Fat Grafting. Plast Reconstr Surg 2022; 150:307e-318e. [PMID: 35666147 DOI: 10.1097/prs.0000000000009337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Facial fat grafts decrease in volume after transplantation. This observation is based on overall facial three-dimensional analyses, because there is sparse information on volume changes in well-defined aesthetic areas. The authors aimed to assess the overall and, more specifically, the local volumetric effects of facial fat grafting and relate these effects to patient satisfaction up to 1 year after treatment. METHODS All consecutive adult female patients who were scheduled for facial fat grafting without additional surgical procedures were asked to participate. All patients underwent the same fat grafting method. An algorithm-based personalized aesthetic template was applied to define specific aesthetic areas on the preoperative three-dimensional image. Objective outcome parameters [i.e., three-dimensional volume differences, patient satisfaction (FACE-Q questionnaire)] were measured at baseline and at 6 weeks, 6 months, and 12 months after fat grafting. RESULTS Of 33 female patients who underwent a facial fat graft procedure, 23 patients had complete three-dimensional data and were eligible for analysis. The highest volume gain was observed 6 weeks after grafting and was followed by a gradual loss thereafter. Overall and in the zygomatic area, a substantial gain in volume was still present 1 year after grafting, whereas this effect was lost in the lip area. FACE-Q scales Satisfaction with Facial Appearance Overall and Satisfaction with Cheeks improved too, whereas scores for Lines: Lips returned to baseline levels. The improvement in FACE-Q scales was in agreement with the objective change in volume. CONCLUSION Gain in overall and local volumetric effects is accompanied by comparable changes in patient satisfaction. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Long - Term Evaluation of Endoscopic - and Pre - Trichial Open Forehead Lifts: a Morphometric Analysis. Plast Reconstr Surg 2022; 150:289-298. [PMID: 35653546 DOI: 10.1097/prs.0000000000009366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study is to evaluate and compare the long-term (average 6 years, range 3-11 years) follow-up results of both the endoscopic - and pre - trichial open forehead lift. Both the amount of eyebrow elevation, as well as patient satisfaction (FACE-Q questionnaires) were analyzed. METHODS Preoperative and postoperative eyebrow positions of sixty-five patients were measured. Both eyebrow sides were measured at three different points. Thirty-two patients completed the FACE-Q questionnaires (10 domains, Dutch translated). RESULTS Both the endoscopic - as well as the pre - trichial open forehead lift raised the eyebrow significantly at all measured points for each eye. This elevation effect was maintained significantly after the long-term evaluation (average 6 years, range 3-11 years) with no significant difference reported among both techniques. After both procedures, patients were satisfied or strongly satisfied according to the FACE-Q questionnaires. CONCLUSION Both the endoscopic - and the pre - trichial open forehead lift raises the eyebrow significantly and both have either a long-term effect with long-lasting satisfied or strongly satisfied patients, as evaluated according to the FACE-Q questionnaire.
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12
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Dayan S, Joseph J, Moradi A, Lorenc ZP, Coleman K, Ablon G, Kaufman-Janette J, Cox SE, Campbell A, Munavalli G, Prygova I. Subject Satisfaction and Psychological Well-being with Escalating AbobotulinumtoxinA Injection Dose for the Treatment of Moderate to Severe Glabellar Lines. J Cosmet Dermatol 2022; 21:2407-2416. [PMID: 35266281 PMCID: PMC9322427 DOI: 10.1111/jocd.14906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/25/2022] [Indexed: 11/29/2022]
Abstract
Background Previous studies indicate that the efficacy and durability of a single AbobotulinumtoxinA (ABO) treatment for moderate to severe glabellar lines may be enhanced with increasing dose, while safety outcomes remain consistent with those of the licensed dose (50 U). Aims Evaluation of subject‐reported indicators of treatment efficacy, satisfaction, and psychological well‐being with ABO dose escalation. Methods A Phase 2, 36‐week, multicenter, randomized, dose‐ranging, double‐blind, placebo‐controlled study was conducted in adults with moderate to severe glabellar lines. Subjects received a single ABO treatment, dosed at 50, 75, 100, or 125 U, or placebo. Efficacy endpoints comprised subject‐assessed improvement in line severity of ≥1‐grade from baseline at maximum frown, global aesthetic improvement scale (GAIS) grade, FACE‐Q™ appraisal of lines, psychological well‐being and age, and subject satisfaction. Results The study included 399 subjects (88.2% were female). Respective responder rates (≥1‐grade improvement) with ABO 50–125 U doses ranged between 96.3%–100% at Week 4, 65.0%–67.9% at Week 24, and 33.8%–44.4% at Week 36. GAIS responder rate and FACE‐Q appraisal of lines showed a similar pattern of change. Satisfaction was high and psychological well‐being was improved from Week 4 through Week 36, with natural, youthful, and refreshed appearance reported for all ABO doses. Conclusions A single ABO treatment (dosed at 50–125 U) provided significant and sustained improvements in glabellar line severity over durations up to 36 weeks, versus placebo. Treatment satisfaction was high with all doses. Participants reported natural and youthful appearance, alongside improvements in psychological well‐being.
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Affiliation(s)
| | - John Joseph
- Clinical Testing of Beverly Hills, Encino, CA, USA
| | | | - Z Paul Lorenc
- Lorenc Aesthetic Plastic Surgery Center, New York, USA
| | - Kyle Coleman
- Etre Cosmetic Dermatology and Laser Center, New Orleans, LA, USA
| | - Glynis Ablon
- Ablon Skin Institute and Research Center, Manhattan Beach, CA, USA
| | | | | | | | - Girish Munavalli
- Dermatology, Laser & Vein Specialists of the Carolinas, PLLC, Charlotte, NC, USA
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Kestemont P, Hilton S, Andriopoulos B, Prygova I, Thompson C, Volteau M, Ascher B. Long-term Efficacy and Safety of Liquid AbobotulinumtoxinA Formulation for Moderate-to-Severe Glabellar Lines: A Phase III, Double-Blind, Randomized, Placebo-Controlled and Open-Label Study. Aesthet Surg J 2022; 42:301-313. [PMID: 34472596 PMCID: PMC8844979 DOI: 10.1093/asj/sjab329] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A ready-to-use liquid formulation of abobotulinumtoxinA (aboBoNT-A solution) has been developed. OBJECTIVES The aim of this study was to assess the long-term efficacy and safety of aboBoNT-A solution for the treatment of glabellar lines. METHODS This was a multicenter, multinational, Phase III study (NCT02493946), with randomized double-blind placebo-controlled (DBPC; 2:1 aboBoNT-A solution 50 U/placebo) and open-label (4 cycles aboBoNT-A solution) periods; additional patients were recruited into the open-label period. Patients were 18 to 65 years old, BoNT-naïve, and dissatisfied/very dissatisfied with moderate/severe glabellar lines at maximum frown. Investigator's live assessment (primary endpoint)/subject's self-assessment of glabellar line severity at maximum frown, patient satisfaction with glabellar line appearance, and FACE-Q patient-reported scales (facial appearance overall, psychological well-being, aging) were assessed. Adverse events were monitored. Analyses were performed on DBPC and long-term analysis (LTA; all patients receiving ≥1 aboBoNT-A solution injection) populations. RESULTS Responder rates for the investigator's live assessment, the subject's self-assessment, and patient satisfaction were consistent at Day 29 postinjection across repeat LTA cycles (82.2%-87.8%, 62.8%-80.6%, and 72.2%-87.8%, respectively), with statistically significantly higher responder rates vs placebo (DBPC cycle: 81.6% vs 0.8%, 68.1% vs 2.3%, and 83.1% vs 5.7%, respectively; all P < 0.0001). Consistent improvements on FACE-Q scales occurred with repeat cycles (DBPC cycle: aboBoNT-A solution vs placebo, P < 0.0001). No new or unexpected adverse events, or neutralizing antibodies, were observed. CONCLUSIONS These results support the long-term efficacy and safety of aboBoNT-A solution, and its superiority over placebo, for treatment of glabellar lines in adults. LEVEL OF EVIDENCE: 1
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Affiliation(s)
- Philippe Kestemont
- Corresponding Author: Dr Philippe Kestemont, Clinique Esthétique St George, 159 avenue de Rimiez, 06100 Nice, France. E-mail:
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Hollander M, Delli K, Vissink A, Schepers R, Jansma J. Patient-reported aesthetic outcomes of upper blepharoplasty: a randomized controlled trial comparing two surgical techniques. Int J Oral Maxillofac Surg 2022; 51:1161-1169. [DOI: 10.1016/j.ijom.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/20/2021] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
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Cohen JL, Rivkin A, Dayan S, Shamban A, Werschler WP, Teller CF, Kaminer MS, Sykes JM, Weinkle SH, Garcia JK. Multimodal Facial Aesthetic Treatment on the Appearance of Aging, Social Confidence, and Psychological Well-being: HARMONY Study. Aesthet Surg J 2022; 42:NP115-NP124. [PMID: 33751048 PMCID: PMC8756087 DOI: 10.1093/asj/sjab114] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background A global approach to facial rejuvenation involves multiple treatment modalities. Objectives The aim of this study was to evaluate the impact of multimodal facial aesthetic treatment on self-reported psychological and social outcomes. Methods HARMONY, a prospective, multicenter, 4-month study, enrolled patients aged 35 to 65 years to receive on-label treatment with a combination of hyaluronic fillers (VYC-20L, HYC-24L, and/or HYC-24L+), onabotulinumtoxinA, and bimatoprost. Fillers were injected on Day 1, with touch-ups performed on Day 14. OnabotulinumtoxinA was injected at Month 3 into glabellar lines and/or crow’s feet lines. Patients applied bimatoprost to eyelashes once daily for 17 weeks. Mean change from baseline on FACE-Q Psychological Well-being and Social Confidence Scales, FACE-Q Aging Appearance Appraisal Scale, and FACE-Q Age Appraisal Visual Analog Scale were assessed. Results Of 100 patients treated, 93 were evaluated at 4 months posttreatment. Significant improvement vs baseline was observed on the FACE-Q Scales for Psychological Well-being (mean change, −19.9; P < 0.00001), Social Confidence (mean change, −18.2; P < 0.00001), and Aging Appearance (mean change, −28.5; P < 0.0001). On average, patients’ self-assessed age was 0.1 years older than actual age at baseline and 4.5 years younger at Month 4 (P < 0.001 vs baseline). Forty-two patients experienced adverse events, all mild to moderate. Conclusions Multimodal, full facial aesthetic treatment improves patients’ self-reported psychological well-being, social confidence, aging appearance, and perceptions of chronologic age. Level of Evidence: 4
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Affiliation(s)
- Joel L Cohen
- Department of Dermatology, University of California, Irvine, CA, USA
| | - Alexander Rivkin
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Steven Dayan
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois, Chicago, IL, USA
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Kaur MN, Baradaran S, Patel V, Klassen AF. Measuring outcomes for temple hollowing treatment: Content validity of new and existing FACE-Q scales. J Cosmet Dermatol 2021; 21:167-175. [PMID: 34855266 DOI: 10.1111/jocd.14646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The FACE-Q, a validated, modular patient-reported outcome measure with global uptake, currently does not have a scale to measure the appearance of the temples. Objectives of our study were to develop a new FACE-Q scale for appearance of temples and assess content validity of two existing FACE-Q scales in the context of temple hollowing: Satisfaction with Facial Appearance and Psychological Function. METHODS A heterogeneous sample of adults who were seeking or had received treatments for temple hollowing was recruited from three outpatient clinics in the United States. Semi-structured interviews using an interpretive description approach were completed to elicit concepts and generate an item pool and assess content validity of the two existing FACE-Q scales. The item pool data were used to develop preliminary Temple scale, which was refined based on patient and expert feedback. RESULTS Participants (N = 15, 55 ± 9 years) described a range of esthetic concerns related to temple hollowing and its treatment. The data were used to draft the FACE-Q Satisfaction with Temples scale, which was refined through input from patients (N = 12) and clinicians (N = 5), resulting in a 16-item FACE-Q Satisfaction with Temples scale. The scale covers concepts of fullness, harmony, scenarios (eg, mirror, bright lights), age, and shape. Content validity of the two existing FACE-Q scales was substantiated. CONCLUSION The FACE-Q Satisfaction with Temples scale fills an important gap in patient-reported outcome measurement in facial esthetics. The scale will be field-tested to finalize content and develop the scoring algorithm prior to implementation in clinical practice and research.
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Wang G, Zhao R, Bi R, Xie H. Subcutaneous Face and Neck lift: A Traditional Method With Definite Effects Among Asians. Aesthet Surg J 2021; 41:NP1890-NP1903. [PMID: 33656547 DOI: 10.1093/asj/sjab053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The mainstream facelifts in Western countries always involve the superficial fascia/superficial musculoaponeurotic system treatment. Meanwhile, subcutaneous face and neck lifts are widely applied among Asians. OBJECTIVES The authors sought to evaluate outcomes of subcutaneous face and neck lift, including patient-reported and 3-dimensional (3D) measurement outcomes, and report on details of surgical procedures. METHODS Patients who received a subcutaneous face and neck lift from January 2017 to June 2019 were asked to complete FACE-Q scales, and facial information was collected by the Vectra 3D imaging system preoperatively and postoperatively. Volume changes in midface and possible displacement of facial landmarks were measured. The range of dissection and the amount of skin removed were recorded intraoperatively. RESULTS In total, 119 patients (median age, 46 years, interquartile range, 40-53 years) received a subcutaneous face and neck lift. Among them, 88 patients completed pre- and postoperative FACE-Q scales. Patients' satisfaction with facial subunits improved and wrinkles were significantly relieved (P < 0.001). Nineteen patients (38 midface sides) completed 3D image data collection. Postoperatively, zygomatic volume increased, and nasolabial and lateral cheek volumes decreased (volume change of 2.2 ± 1.3 mL). Mouth, nose, and eye displacements were negligible postoperatively. The widths of skin removed at the middle temporal, front of the sideburns, upper helix, earlobe, and retro-auricular were 13.8 ± 1.9 mm, 19.6 ± 3.1 mm, 27.6 ± 3.9 mm, 16.4 ± 3.9 mm, and 32.2 ± 4.0 mm, respectively. CONCLUSIONS The authors' subcutaneous face and neck lift was effective in relieving nasolabial sagging, improving wrinkles, and achieving facial rejuvenation. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Guanhuier Wang
- Department of Plastic Surgery, Peking University 3rd Hospital, Beijing, China
| | - Runlei Zhao
- Department of Plastic Surgery, Peking University 3rd Hospital, Beijing, China
| | - Ran Bi
- Beijing Myyoung Cosmetic Surgery Hospital, Beijing, China
| | - Hongbin Xie
- Department of Plastic Surgery, Peking University 3rd Hospital, Beijing, China
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Effect of Age on Satisfaction with Facial Appearance in Women Based on the FACE-Q Questionnaire in a Dutch Normative Population. Plast Reconstr Surg 2021; 148:679e-681e. [PMID: 34495923 DOI: 10.1097/prs.0000000000008359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Cosmetic procedures have demonstrated beneficial effects on physical appearance based on anatomic markers as well as patient-perceived self-image and quality of life. Recent studies of observer-reported outcomes (OROs) suggest an additional benefit from aesthetic interventions. OBJECTIVE The authors aimed to review the evidence of OROs from cosmetic procedures performed on the head and neck. PATIENTS, METHODS AND MATERIALS PubMed, Embase, and Cochrane Library databases were searched for relevant studies, yielding 24 included original investigations. RESULTS These studies captured 686 total patients, 8,257 observer evaluations, and a variety of interventions including face-lifts, blepharoplasty, rhinoplasty, and minimally invasive treatments including botulinum toxins and hyaluronic acid fillers. Forty-one distinct reported OROs were grouped into 12 descriptive domains. Domains were further grouped into 3 higher-order categories: aesthetics and wellness, social capacities, and skills and competencies. Improved perception after cosmetic intervention is most reproducibly demonstrated for the following ORO domains: age, attractiveness, sociability, relationship success, and occupational and financial competency. CONCLUSION The synthesized findings imply a tertiary layer of benefit for cosmetic intervention beyond anatomical and patient-centered outcomes through enhanced perceptions of others. These findings may inform the pre-procedure risk-benefit discussion with patients of cosmetic medicine and drive future research into longitudinal outcomes.
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Affiliation(s)
- Payal Shah
- Both authors are affiliated with The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
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Maximizing Panfacial Aesthetic Outcomes: Findings and Recommendations From the HARMONY Study. Dermatol Surg 2020; 46:810-817. [PMID: 31834076 DOI: 10.1097/dss.0000000000002271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aesthetic medicine has evolved from targeting individual treatment areas to a global approach of panfacial rejuvenation. HARMONY was the first clinical study to systematically demonstrate positive physical and psychosocial impacts of panfacial treatment. OBJECTIVE Provide evidence-based guidance on treatment strategies to help maximize outcomes in patients seeking panfacial rejuvenation. MATERIALS AND METHODS Study sites with the lowest (n = 2) and highest (n = 2) improvements based on FACE-Q Satisfaction with Face Overall scores were analyzed to understand differences in treatment strategy that may contribute to incrementally greater patient satisfaction. RESULTS The highest scoring sites exhibited greater improvement in all patient-reported outcomes and investigator-assessed measures related to dermal filler treatment compared with the lowest scoring sites. The highest sites favored lateral malar augmentation and used less volume medially versus the lowest sites. In the lower face, the highest sites used greater volumes and more HYC-24L than HYC-24L+. Initial treatment volumes were more conservative at highest than lowest sites; greater volumes were used by highest sites in touch-up treatments. CONCLUSION Product usage trends common to the highest scoring sites (including injection volume, injection sites, and product selection) may provide guidance on best practices for a panfacial approach to aesthetic treatment to maximize patient satisfaction.
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Barbarino SC, Woodward JA, Levine J, Fezza J. Evaluating an incobotulinumtoxinA and Cohesive Polydensified Matrix ® hyaluronic acid filler combination to treat moderate-to-severe periorbital and perioral rhytids. J Cosmet Dermatol 2020; 20:1459-1466. [PMID: 33051971 DOI: 10.1111/jocd.13745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/02/2020] [Accepted: 09/17/2020] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the effectiveness of treating mimetic facial lines with an incobotulinumtoxinA (INCO) and Cohesive Polydensified Matrix® hyaluronic acid (CPM-HA) combination. METHODS Subjects with moderate-to-severe lateral periorbital lines (LPL) and perioral lines at rest according to Merz Aesthetics Scales™ received 10 U of INCO/eye and up to 10 U to the perioral area. This was followed by intradermal injection of 1-3 cc CPM-HA to the same lines. Primary outcomes were physician- and subject-rated improvement at 1 month using the Global Aesthetic Improvement Scale (GAIS) and changes in line severity using the Merz Aesthetics Scales™ . RESULTS The study included 10 women aged 42-74 years with moderate-to-severe LPL and perioral lines at baseline. At 1 month, treating physician GAIS scores indicated 45.0% of subjects were very much improved and 52.5% much improved; 75% remained at least improved at 6 months. Subject GAIS results indicated 7 women rated themselves as very much improved and 3 as much improved. For LPL, improvements of ≥1-point on the Merz Aesthetics Scales™ compared with baseline were seen at 1, 3, and 6 months in 86.8%, 74.3%, and 65.8% of subjects, respectively. For perioral lines, improvements of ≥1-point were observed for 89.2%, 86.5%, and 73.0% at 1, 3, and 6 months, respectively. No treatment-related adverse events were observed. CONCLUSIONS Combined INCO/CPM-HA filler in individuals with moderate-to-severe LPL and perioral lines was effective at improving overall appearance and reducing line severity in two highly mobile facial areas that are the first to show lines of aging.
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Affiliation(s)
| | - Julie A Woodward
- Department of Ophthalmology and Department of Dermatology, Duke University Medical Center, Durham, NC, USA
| | - Jennifer Levine
- Lenox Hill Hospital, Manhattan Eye Ear and Throat Hospital, New York, NY, USA
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Ascher B, Rzany B, Kestemont P, Hilton S, Heckmann M, Bodokh I, Noah EM, Boineau D, Kerscher M, Volteau M, Le Berre P, Picaut P. Significantly Increased Patient Satisfaction Following Liquid Formulation AbobotulinumtoxinA Treatment in Glabellar Lines: FACE-Q Outcomes From a Phase 3 Clinical Trial. Aesthet Surg J 2020; 40:1000-1008. [PMID: 31550352 PMCID: PMC7427150 DOI: 10.1093/asj/sjz248] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The FACE-Q patient-reported outcome assesses patient experiences/outcomes with aesthetic facial procedure. A recent trial of abobotulinumtoxinA (ASI, liquid formulation) was the first to our knowledge to assess satisfaction with FACE-Q after glabellar line (GL) injection. Objectives The authors sought to evaluate patient satisfaction with ASI for GL treatment employing 3 FACE-Q scales: facial appearance, psychological well-being, and aging appearance. Methods This was a Phase 3, randomized, double-blind, placebo-controlled trial (NCT02353871) of ASI 50 units in adults with moderate-to-severe GL with 6-month follow-up. Results Significantly greater least squares mean changes from baseline were associated with ASI treatment (N = 125) vs placebo (N = 59) for satisfaction with facial appearance at all visits until day 148 (5 months; P < 0.0001-0.0037), psychological well-being at all visits (P < 0.0001-0.0279), and aging appearance at all visits except day 148 (P < 0.0001-0.0409). Significant differences (ASI vs placebo) were observed at all visits for individual items: “how rested your face looks” (P < 0.0001-0.0415), “I feel okay about myself” (P = 0.0011-0.0399), and “I feel attractive” (P < 0.0001-0.0102). Maximal least squares mean (standard error) changes in aging appearance score were −1.4 (0.3; ASI) and −0.3 (0.4; placebo). Investigators’ live assessment of GL at maximum frown significantly correlated with improvements in FACE-Q facial appearance and psychological scales (all patients: r = −0.41 and r = −0.36 [both P < 0.0001], respectively). Conclusions Significant improvements in patient satisfaction with aging, facial appearance, and, importantly, psychological well-being were demonstrated with ASI employing FACE-Q scales up to 5 to 6 months post-injection. Results support a long duration of efficacy with ASI and use of FACE-Q in future trials and clinical practice. Level of Evidence: 1 ![]()
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Affiliation(s)
| | | | | | | | | | - Isaac Bodokh
- Dermatology Department, Cannes Hospital, Cannes, France
| | - Ernst Magnus Noah
- Division of Plastic and Reconstructive Surgery, Red Cross Hospital, Kassel, Germany
| | | | - Martina Kerscher
- Division of Cosmetic Science, Department of Chemistry, University of Hamburg, Hamburg, Germany
| | - Magali Volteau
- Neurology Development, Ipsen Innovation, Les Ulis, Paris, France
| | | | - Philippe Picaut
- Neurology Development, Ipsen Innovation, Les Ulis, Paris, France
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Gold MH, Andriessen A, Hu S, Vega JH, Goldberg DJ, Grover KV, Lorenc ZP, Mandy SH. Physician survey on pre-/postprocedure measures for injectable treatments. J Cosmet Dermatol 2020; 19:2246-2251. [PMID: 32738101 DOI: 10.1111/jocd.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Every year in the United States, over 1 billion dollars are spent on aesthetic injectables, such as soft tissue fillers and neurotoxins. In 2018, the total amount of injectable treatments performed surpassed 2 671 130 procedures. While often mild and transient, adverse events (AEs) can occur following these procedures. AEs may include common side effects such as bruising, or rare, but serious AEs such as infections. While previous investigators have evaluated methods of reducing risks of AEs due to the treatment procedure itself, few investigations have evaluated measures employed before and/or after treatment (ie, peri-procedure). METHODS An electronic survey was sent to aesthetic clinicians with experience performing injectable treatments. The survey collected information regarding general information (eg, demographics and specialty), type of injectable devices used, current peri-procedures, and an exploration of future options for peri-procedural measures. RESULTS Most aesthetic clinicians did not use prophylactic topical or systemic antimicrobials, nor prophylactic topical antiviral therapy. However, approximately 65% of clinicians reported using prophylactic systemic antivirals for patients with a history of herpes simplex virus. A variety of products were used to prepare the skin prior to injectable procedures. Postprocedure, multiple over-the-counter wound repair products were recommended by >70% of injectors. However, there was a large variety of products recommended with no majority consensus. CONCLUSIONS Currently, there are no peri-procedural standards of practice when performing aesthetic injectable treatments. Efforts are underway for the development of best-practice algorithms.
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Affiliation(s)
- Michael H Gold
- Gold Skin Care Center and Tennessee Clinical Research Center, Nashville, TN, USA.,University School of Medicine and Nursing, Nashville, TN, USA
| | - Anneke Andriessen
- Radboud UMC Nijmegen, Andriessen Consultants, Malden, The Netherlands
| | - Shasa Hu
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Dermatology and Cutaneous Surgery, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - David J Goldberg
- Skin Laser & Surgery Specialists of NY and NJ, Hackensack, NJ, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Komel V Grover
- Strategic Development, Swiss American CDMO, Dallas, TX, USA
| | - Z Paul Lorenc
- Lorenc Aesthetic Plastic Surgery Center, New York, NY, USA.,Department of Plastic Surgery, Lenox Hill Hospital, New York, NY, USA
| | - Stephen H Mandy
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Post-rhinoplasty outcomes in an Indian population assessed using the FACE-Q appraisal scales: a prospective observational study. The Journal of Laryngology & Otology 2020; 134:247-251. [PMID: 32172693 DOI: 10.1017/s0022215120000638] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The primary goal of rhinoplasty is patient satisfaction and improved quality of life. The present study was conducted to assess patient satisfaction with face and nose appearance, and quality of life after rhinoplasty. METHODS Patients presenting for rhinoplasty completed the FACE-Q survey. This is a new instrument that measures patient-reported outcomes in those undergoing aesthetic procedures. The FACE-Q scales include satisfaction with facial appearance overall, satisfaction with the nose, psychological well-being, psychosocial distress and social function. RESULTS Sixty-five patients completed the FACE-Q at pre-operative and at post-operative follow-up visits. Post-operative scores increased significantly in terms of: satisfaction with facial appearance (p < 0.0001, t = 15.639, degrees of freedom = 64); social function (p < 0.0001, t = 12.208, degrees of freedom = 64); psychosocial distress (p < 0.0001, t = 13.864, degrees of freedom = 64); psychological function (p < 0.0001, t = 12.681, degrees of freedom = 64); and satisfaction with nose (p < 0.0001, t = 16.421, degrees of freedom = 64). Most patients reported more than 79 per cent satisfaction with the post-operative outcome. CONCLUSION The FACE-Q is an adequate instrument for determining successful aesthetic surgery based on patient satisfaction.
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The Impacts of Orthognathic Surgery on the Facial Appearance and Age Perception of Patients Presenting Skeletal Class III Deformity. Plast Reconstr Surg 2020; 145:1035-1046. [PMID: 32221228 DOI: 10.1097/prs.0000000000006650] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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La Padula S, Hersant B, Bompy L, Meningaud JP. In search of a universal and objective method to assess facial aging: The new face objective photo-numerical assessment scale. J Craniomaxillofac Surg 2019; 47:1209-1215. [DOI: 10.1016/j.jcms.2019.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/18/2019] [Accepted: 03/11/2019] [Indexed: 01/07/2023] Open
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Bustillo AMB, Lobato RC, Luitgards BF, Camargo CP, Gemperli R, Ishida LC. Translation, Cross-Cultural Adaptation and Linguistic Validation of the FACE-Q Questionnaire for Brazilian Portuguese. Aesthetic Plast Surg 2019; 43:930-937. [PMID: 31089752 DOI: 10.1007/s00266-019-01399-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese. METHODS This cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed. RESULTS Translation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n = 222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n = 87), TB in 27% and a new version in 11% (n = 40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8 years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version. CONCLUSION A Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
| | - Rodolfo Costa Lobato
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
- , São Paulo, Brazil.
| | - Bruno Ferreira Luitgards
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Pires Camargo
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rolf Gemperli
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Carlos Ishida
- Plastic Surgery Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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A Systematic Review of Patient-Reported Outcomes for Cosmetic Indications of Botulinum Toxin Treatment. Dermatol Surg 2019; 45:668-688. [DOI: 10.1097/dss.0000000000001878] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Assessing Improvement of Patient Satisfaction Following Facelift Surgery Using the FACE-Q Scales: A Prospective and Multicenter Study. Aesthetic Plast Surg 2019; 43:370-375. [PMID: 30488241 DOI: 10.1007/s00266-018-1277-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Assessment of patient satisfaction following an aesthetic surgery has shown an increasing trend over the past years. To date, there is no prospective and comprehensive study evaluating this aspect after surgical facial and neck rejuvenation. The aim of the current work was to address patient satisfaction after face and neck lift surgery using a validated questionnaire. PATIENTS AND METHODS We present a prospective and multicenter study (five regional centers) involving all patients undergoing face and neck lift surgery between April 2015 and April 2017 in several French centers for aesthetic surgery. All subjects assessed the FACE-Q scales before the procedure, and furtherly at 3-month, 6-month and 12-month follow-ups. RESULTS Thirty-six patients were included with a median age of 58.5 years old [IQR 54.0-66.0]. The FACE-Q outcomes were significantly higher at 3-month follow-up (p < 0.001). Seventy-five percent of the patients underwent an additional surgical procedure associated with face and neck lift. Particularly, a combined blepharoplasty led to a significant increase in the score of global facial appearance. The patients considered themselves a mean of 6 years younger in the third month after surgery. These results remained constant at six and twelve postoperative months. CONCLUSION A statistically significant improvement of the FACE-Q scores could be highlighted on every scale, with permanent results at 6 and 12 months postsurgery. We hereby present the first study with evidence that appearance and quality of life outcomes can be reliably assessed after rhytidectomy. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Chang CS, Chang BL, Lanni M, Wilson AJ, Beer J, Percec I. Perioral Rejuvenation: A Prospective, Quantitative Dynamic Three-Dimensional Analysis of a Dual Modality Treatment. Aesthet Surg J 2018; 38:1225-1236. [PMID: 29506030 DOI: 10.1093/asj/sjy060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The perioral region is the most dynamic anatomic area of the face and subject to complex and dramatic changes during aging. Successful treatment for perioral rejuvenation has yet to be identified, and prior studies have reported only subjective outcomes. OBJECTIVES The purpose of this study was to utilize our validated dynamic 3-dimensional imaging technology to determine whether conservative neuromodulation combined with hyaluronic acid filler volumization can decrease perioral strain and increase volume with significant patient satisfaction. METHODS An IRB-approved prospective study of a dual modality treatment for perioral rhytids was performed on females with perioral aging who had not had prior facial treatment within the past year. Eighteen (18) units of Dysport were injected into the upper and lower orbicularis oris and 1 cc of Restylane Silk was injected in volume-depleted perioral regions in each patient. Each patient underwent imaging with digital image correlation (DIC) and completed the FACE-Q survey prior to injection and at 14 days and 90 days postinjection. RESULTS Thirty-two female patients were recruited. A significant reduction in perioral strain was observed at both day 14 and day 90. This was concomitant with a significant increase in perioral volume at day 14 that at 90 days was significantly retained in the marionette lines. Further, there was a significant improvement in patient satisfaction with overall facial appearance at day 14 that was maintained at 90 days. CONCLUSIONS Conservative neuromodulation and hyaluronic acid filler volumization of the perioral region produces a significant reduction in strain correlating with high patient satisfaction, even at 90 days. This dual modality treatment is effective in rejuvenating the perioral region, and its future optimization will provide greater therapeutic options for this anatomically complex area. LEVEL OF EVIDENCE 4
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Affiliation(s)
- Catherine S Chang
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Brian L Chang
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Michael Lanni
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Anthony J Wilson
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Jacob Beer
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Ivona Percec
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
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Élaboration d’un questionnaire de satisfaction encadrant la chirurgie de féminisation faciale chez les patientes transsexuelles male to female (QESFF1) : Phase qualitative. ANN CHIR PLAST ESTH 2018; 63:205-214. [DOI: 10.1016/j.anplas.2017.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 12/29/2017] [Indexed: 01/10/2023]
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Lee EH, Klassen AF, Cano SJ, Nehal KS, Pusic AL. FACE-Q Skin Cancer Module for measuring patient-reported outcomes following facial skin cancer surgery. Br J Dermatol 2018; 179:88-94. [PMID: 29654700 DOI: 10.1111/bjd.16671] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND The patient's perspective of their facial scar after skin cancer surgery influences perception of care and quality of life (QoL). Appearance satisfaction after surgery is also an important but often overlooked treatment outcome. OBJECTIVES To report the psychometric validation of the FACE-Q Skin Cancer Module consisting of five scales, measuring appearance satisfaction (Satisfaction with Facial Appearance, Appraisal of Scars), QoL (Cancer Worry, Appearance-related Psychosocial Distress) and the patient experience (Satisfaction with Information: Appearance). METHODS Participants underwent Mohs surgery for facial basal or squamous cell carcinoma or excision of early facial melanoma. Cohort 1 received a set of scales before and after surgery. Cohort 2 received the scales on two occasions in the postoperative period for test-retest reliability. Rasch measurement theory was used to select (item-reduce) the most clinically meaningful items for the scales. Reliability, validity, floor and ceiling effects and responsiveness were also analysed. RESULTS Of 334 patients, 209 (response rate 62·6%) were included. Rasch analysis reduced the total scale items from 77 to 41. All items had ordered thresholds and good psychometric fit. Reliability was high (Person separation index and Cronbach's α ≥ 0·90) and scales measuring similar constructs were correlated. High floor and ceiling effects were seen for the scales. The Cancer Worry scale demonstrated responsiveness (P = 0·004). CONCLUSIONS The FACE-Q Skin Cancer Module meet the requirements of the Rasch model providing linearized measurement. Discriminating between patients with minimal appearance or worry impairment may be a limitation. The scales can be used for larger validation studies, clinical practice and research.
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Affiliation(s)
- E H Lee
- Dermatology Division, Memorial Sloan Kettering Cancer Center, 16 East 60th St, New York, NY, 10022, U.S.A
| | - A F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - S J Cano
- Modus Outcomes, Letchworth, Garden City, U.K
| | - K S Nehal
- Dermatology Division, Memorial Sloan Kettering Cancer Center, 16 East 60th St, New York, NY, 10022, U.S.A
| | - A L Pusic
- Plastic and Reconstructive Surgery Division, Brigham and Women's Hospital, Boston, MA, U.S.A
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Qureshi AA, Parikh RP, Sharma K, Myckatyn TM, Tenenbaum MM. Nonsurgical Facial Rejuvenation: Outcomes and Safety of Neuromodulator and Soft-Tissue Filler Procedures Performed in a Resident Cosmetic Clinic. Aesthetic Plast Surg 2017; 41:1177-1183. [PMID: 28547293 PMCID: PMC7558437 DOI: 10.1007/s00266-017-0892-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 04/30/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The ability to perform nonsurgical facial rejuvenation procedures is a core competency requirement for plastic surgery residents. However, limited data exist on training models to achieve competency in nonsurgical facial rejuvenation and on outcomes of these procedures performed by residents. The purpose here is to evaluate patient-reported outcomes and safety of nonsurgical facial rejuvenation procedures performed by plastic surgery residents. METHODS We prospectively enrolled 50 patients undergoing neuromodulator and/or soft-tissue filler injections in a resident cosmetic clinic between April and August 2016. Patients completed FACE-Q modules pre-procedure, and at 1 week and 1 month post-procedure. Paired t-tests were used to calculate statistical significance of changes between pre- and post-procedure scores. Effect sizes were calculated to assess clinical improvement from pre- to post-procedure. The magnitude of change was interpreted using Cohen's arbitrary criteria (small 0.20, moderate 0.50, large 0.80). RESULTS Forty-five patients completed the study. Patients experienced significant improvements (p < 0.001) in all FACE-Q domains, including aging appearance appraisal (improved from 49.7 ± 29.4 to 70.1 ± 21.6, effect size 0.79), psychological well-being (44.0 ± 14.6-78.6 ± 20.7, effect size 1.93), social functioning (48.6 ± 16.6-75.5 ± 21.7, effect size 1.20), and satisfaction with facial appearance (50.1 ± 13.7-66.2 ± 19.7, effect size 0.95). At 1 month, overall satisfaction with outcome and decision were 75.8 ± 20.7 and 81.1 ± 20.4, respectively. No patients experienced complications. CONCLUSIONS Nonsurgical facial rejuvenation procedures performed by residents can improve patients' quality of life and provide high satisfaction without compromising safety. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
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Affiliation(s)
- Ali A Qureshi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 1020 North Mason Rd., Suite 110, Building 3, St. Louis, MO, 63141, USA
| | - Rajiv P Parikh
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 1020 North Mason Rd., Suite 110, Building 3, St. Louis, MO, 63141, USA
| | - Ketan Sharma
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 1020 North Mason Rd., Suite 110, Building 3, St. Louis, MO, 63141, USA
| | - Terence M Myckatyn
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 1020 North Mason Rd., Suite 110, Building 3, St. Louis, MO, 63141, USA
| | - Marissa M Tenenbaum
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 1020 North Mason Rd., Suite 110, Building 3, St. Louis, MO, 63141, USA.
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Carroll TL, Lee SE, Lindsay R, Locandro D, Randolph GW, Shin JJ. Evidence-Based Medicine in Otolaryngology, Part 6: Patient-Reported Outcomes in Clinical Practice. Otolaryngol Head Neck Surg 2017; 158:8-15. [DOI: 10.1177/0194599817731759] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The assessment of patient-reported outcome measures (PROMs) in the outpatient setting is gaining momentum in clinical and research venues. Implementing this data capture into one’s practice, however, is not a one-size-fits-all venture, and it is critical to determine when, how, and where to include these patient-centered assessments. This installment of the “Evidence-Based Medicine in Otolaryngology” series provides insight into the implementation process and experiences with successful incorporation of PROMs into clinical practice. Specifically, 4 differing clinical scenarios and collection techniques are described, including data acquisition protocols, formats for clinician data usage, and applications of PROM results in clinical and research scenarios.
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Affiliation(s)
- Thomas L. Carroll
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Stella E. Lee
- Division of Sinonasal Disorders and Allergy, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Robin Lindsay
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Drew Locandro
- Northwest ENT and Allergy Center, Marietta, Georgia, USA
| | - Gregory W. Randolph
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer J. Shin
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
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Flageul G, Pessis R. [Prevention of the post-surgical insatisfactions and possible medico-legal complications]. ANN CHIR PLAST ESTH 2017; 62:579-591. [PMID: 28797531 DOI: 10.1016/j.anplas.2017.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022]
Abstract
The purpose of this work is to better understand the reasons for post-surgical instability and what makes up the bed of medico-legal complications. Beyond technical competence, it is essential to observe a very high degree of rigor in listening to the real motivations in order to give the most accurate possible surgical indications and in particular to know to detect and never to operate certain patients who, whatever we do, will always be dissatisfied. The quality of information is one of the essential elements of prevention: information is part of the care and there is no therapeutic success without a successful relationship between a caregiver and a carereceiver. Before the surgery, it is essential to pre-establish written proof of the proper delivery of the information by signing a receipt and an informed consent document. However, the information does not stop at the time of the operative gesture and it is necessary to be able to provide complete and timely information about any post-surgical complications. Furthermore, aesthetic medicine is well understood and rigorously implemented, contributes to the prevention of surgical and medico-legal complications, reducing the heaviness of certain surgical gestures. The question of e-reputation should in no way be neglected. From this point of view, prevention consists in controlling as much as possible the Internet environment. Indeed, where, in the past, in the presence of a dissatisfied patient awaited us, the fear of word-of-mouth or trial is added to the risk of harm E-reputation whose implications can be very damaging. At a time when the intensive use of the Internet allows anyone to get out of anonymity, we must also control these tools at the risk of sacrificing our expertise at the coronation of amateurs.
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Affiliation(s)
- G Flageul
- 59, avenue Franklin-D.-Roosevelt, 75008 Paris, France.
| | - R Pessis
- 82, boulevard de Courcelles, 75017 Paris, France
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Chen B, Song H. Measuring satisfaction with appearance: Validation of the FACE-Q scales for double-eyelid blepharoplasty with minor incision in young Asians- retrospective study of 200 cases. J Plast Reconstr Aesthet Surg 2017; 70:1129-1135. [DOI: 10.1016/j.bjps.2017.05.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 04/19/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
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Klassen AF, Cano SJ, Grotting JC, Baker SB, Carruthers J, Carruthers A, Van Laeken N, Sykes JM, Schwitzer JA, Pusic AL. FACE-Q Eye Module for Measuring Patient-Reported Outcomes Following Cosmetic Eye Treatments. JAMA FACIAL PLAST SU 2017; 19:7-14. [PMID: 27631534 DOI: 10.1001/jamafacial.2016.1018] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Aesthetic eye treatments can dramatically change a person's appearance, but outcomes are rarely measured from the patient perspective. The patient perspective could be measured using an eye-specific patient-reported outcome measure. Objective To describe the development and psychometric evaluation of FACE-Q scales and an adverse effect checklist designed to measure outcomes following cosmetic eye treatments. Design, Setting, and Participants Pretreatment and posttreatment patients 18 years and older who had undergone facial aesthetic procedures were recruited from plastic surgery clinics in United States and Canada and completed FACE-Q scales between June 6, 2010, and July 14, 2014. We used Rasch Measurement Theory, a modern psychometric approach, to refine the scales and to examine psychometric properties. Main Outcomes and Measures The FACE-Q Eye Module, which has 4 scales that measure appearance of the eyes, upper and lower eyelids, and eyelashes. Scale scores range from 0 (worst) to 100 (best). The module also includes a checklist measuring postblepharoplasty adverse effects. Results Overall, 233 patients (81% response rate) 18 years and older participated. Adverse effects included being bothered by eyelid scars, dry eyes, and eye irritation. In Rasch Measurement Theory analysis, each scale's items had ordered thresholds and good item fit. Person Separation Index and Cronbach α were greater than or equal to 0.83. Higher scores on the eye scales correlated with fewer adverse effects (range, -0.26 to -0.36). In the pretreatment group, older age correlated with lower scores (range, -0.42 to -0.51) on the scales measure appearance of the eyes and upper and lower eyelids. Compared with the pretreatment group, posttreatment participants reported significantly better scores on the scales measuring appearance of eyes overall, as well as upper and lower eyelids. Conclusions and Relevance The FACE-Q Eye Module can be used in clinical practice, research and quality improvement to collect evidence-based outcomes data. Level of Evidence NA.
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Affiliation(s)
| | - Stefan J Cano
- Can to Modus Outcomes, Letchworth Garden City, England
| | | | | | - Jean Carruthers
- Department of Ophthalmology, University of British Columbia, Vancouver, Canada
| | - Alastair Carruthers
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
| | - Nancy Van Laeken
- Division of Plastic Surgery, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Andrea L Pusic
- Memorial Sloan Kettering Cancer Center, New York, New York
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Abstract
BACKGROUND In aesthetic clinical practice, surgical outcome is best measured by patient satisfaction and quality of life. For many years, there has been a lack of validated questionnaires. Recently, the FACE-Q was introduced, and the authors present the largest series of face-lift patients evaluated by the FACE-Q with the longest follow-up to date. METHODS Two hundred consecutive patients were identified who underwent high-superficial musculoaponeurotic system face lifts, with or without additional facial rejuvenation procedures, between January of 2005 and January of 2015. Patients were sent eight FACE-Q scales and were asked to answer questions with regard to their satisfaction. Rank analysis of covariance was used to compare different subgroups. RESULTS The response rate was 38 percent. Combination of face lift with other procedures resulted in higher satisfaction than face lift alone (p < 0.05). Patients who underwent lipofilling as part of their face lift showed higher satisfaction than patients without lipofilling in three subscales (p < 0.05). CONCLUSIONS Facial rejuvenation surgery, combining a high-superficial musculoaponeurotic system face lift with lipofilling and/or other facial rejuvenation procedures, resulted in a high level of patient satisfaction. The authors recommend the implementation of the FACE-Q by physicians involved in aesthetic facial surgery, to validate their clinical outcomes from a patient's perspective.
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Cohen JL, Scuderi N. Safety and Patient Satisfaction of AbobotulinumtoxinA for Aesthetic Use: A Systematic Review. Aesthet Surg J 2017; 37:S32-S44. [PMID: 28388721 PMCID: PMC5434490 DOI: 10.1093/asj/sjx010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A systematic review of the published literature (from January 2000 to January 2016) to ascertain the safety of, and patient satisfaction with, the aesthetic use of abobotulinumtoxinA was conducted. In addition to the licensed indications, other special populations were considered for discussion. The potential impact of neutralizing antibodies and systemic toxicity were also addressed. A total of 364 papers were screened and 86 were found to be relevant to the population, intervention(s), and outcomes stipulated in the protocol. The safety and patient satisfaction data from these publications are discussed in this review.
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Affiliation(s)
- Joel L Cohen
- Associate Clinical Professor, Department of Dermatology, University of Colorado, Boulder, CO, USA
- Assistant Clinical Professor, Department of Dermatology, University of California Irvine, Irvine, CA, USA
| | - Nicolo Scuderi
- Full Professor of Plastic and Reconstructive Surgery, Department of Surgery, Sapienza University of Rome, Rome, Italy
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Klassen AF, Cano SJ, Alderman A, East C, Badia L, Baker SB, Robson S, Pusic AL. Self-Report Scales to Measure Expectations and Appearance-Related Psychosocial Distress in Patients Seeking Cosmetic Treatments. Aesthet Surg J 2016; 36:1068-78. [PMID: 27222106 PMCID: PMC5029370 DOI: 10.1093/asj/sjw078] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The use of screening scales in cosmetic practices may help to identify patients who require education to modify inappropriate expectations and/or psychological support. OBJECTIVES To describe the development and validation of scales that measure expectations (about how one's appearance and quality of life might change with cosmetic treatments) and appearance-related psychosocial distress. METHODS The scales were field-tested in patients 18 years and older seeking facial aesthetic or body contouring treatments. Recruitment took place in clinics in the United States, United Kingdom, and Canada between February 2010 and January 2015. Rasch Measurement Theory (RMT) analysis was used for psychometric evaluation. Scale scores range from 0 to 100; higher scores indicate more inappropriate expectations and higher psychosocial distress. RESULTS Facial aesthetic (n = 279) and body contouring (n = 90) patients participated (97% response). In the RMT analysis, all items had ordered thresholds and acceptable item fit. Person Separation Index and Cronbach alpha values were 0.88 and 0.92 for the Expectation scale, and 0.81 and 0.89 for the Psychosocial Distress scale respectively. Higher expectation correlated with higher psychosocial distress (R = 0.40, P < .001). In the facial aesthetic group, lower scores on the FACE-Q Satisfaction with Appearance scale correlated with higher expectations (R = -0.27, P = .001) and psychosocial distress (R = -0.52, P < .001). In the body contouring group, lower scores on the BODY-Q Satisfaction with Body scale correlated with higher psychosocial distress (R = -0.31, P = .003). Type of treatment and marital status were associated with scale scores in multivariate models. CONCLUSIONS Future research could examine convergent and predictive validity. As research data are accumulated, norms and interpretation guidelines will be established. LEVEL OF EVIDENCE 2 Risk.
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Affiliation(s)
- Anne F Klassen
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Stefan J Cano
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Amy Alderman
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Charles East
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Lydia Badia
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Stephen B Baker
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Sam Robson
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Andrea L Pusic
- Dr Klassen is an Associate Professor, Department of Pediatrics, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Dr Cano is the Chief Scientific Officer of Modus Outcomes, Boston, MA. Dr Alderman is a plastic surgeon in private practice in Alpharetta, GA. Mr East is a Facial Plastic Surgeon in the Craniofacial Service, University College London Hospitals, and an Honorary Senior Lecturer, University College London Hospitals, London, UK. Ms Badia is a facial plastic surgeon in private practice in London, UK. Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC. Dr Robson is a physician in private practice in Aberdeen, Scotland. Dr Pusic is a Plastic Surgeon and Associate Professor, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
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Klassen AF, Cano SJ, Schwitzer JA, Baker SB, Carruthers A, Carruthers J, Chapas A, Pusic AL. Development and Psychometric Validation of the FACE-Q Skin, Lips, and Facial Rhytids Appearance Scales and Adverse Effects Checklists for Cosmetic Procedures. JAMA Dermatol 2016; 152:443-51. [PMID: 26934294 DOI: 10.1001/jamadermatol.2016.0018] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Patient-reported outcomes data are needed to determine the efficacy of cosmetic procedures. OBJECTIVE To describe the development and psychometric evaluation of 8 appearance scales and 2 adverse effect checklists for use in minimally invasive cosmetic procedures. DESIGN, SETTING, AND PARTICIPANTS We performed a psychometric study to select the most clinically sensitive items for inclusion in item-reduced scales and to examine reliability and validity with patients. Recruitment of the sample for this study took place from June 6, 2010, through July 28, 2014. Data analysis was performed from December 11, 2014, to December 22, 2015. Pretreatment and posttreatment patients 18 years and older who were consulting for any type of facial aesthetic treatment were studied. Patients were from plastic surgery and dermatology outpatient clinics in the United States and Canada (field-test sample) and a clinical trial of a minimally invasive lip treatment in the United Kingdom and France (clinical trial sample). MAIN OUTCOMES AND MEASURES The FACE-Q scales that measure appearance of the skin, lips, and facial rhytids (ie, overall, forehead, glabella, lateral periorbital area, lips, and marionette lines), with scores ranging from 0 (lowest) to 100 (highest), and the FACE-Q adverse effects checklists for problems after skin and lip treatment. RESULTS Of 783 patients recruited, 503 field-test patients (response rate, 90%) and 280 clinical trial participants were studied. The mean (SD) age of the patients was 47.4 (14.0) years in the field-test sample and 47.7 (12.3) years in the clinical trial sample. Most of the patients were female (429 [85.3%] in the field-test sample and 274 [97.9%] in the clinical trial sample). Rasch Measurement Theory analyses led to the refinement of 8 appearance scales with 66 total items. All FACE-Q scale items had ordered thresholds and acceptable item fit. Reliability, measured with the Personal Separation Index (range, 0.88-0.95) and Cronbach α (range, 0.93-0.98), was high. Lower scores for appearance scales that measured the skin (r = -0.48, P < .001), lips (r = -0.21, P = .001), and lip rhytids (r = -0.32, P < .001) correlated with the reporting of more skin- and lip-related adverse effects. Higher scores for the 8 appearance scales correlated (range, 0.70-0.28; P < .001) with higher scores on the core 10-item FACE-Q satisfaction with facial appearance scale. In the pretreatment group, older age was significantly correlated with lower scores on 5 of the 6 rhytids scales (exception was forehead rhytids) (range, -0.28 to -0.65; P = .03 to <.001). Pretreatment patients reported significantly lower scores on 7 of the 8 appearance scales compared with posttreatment patients (exception was skin) (P < .001 to .005 on independent sample t tests). CONCLUSIONS AND RELEVANCE The FACE-Q appearance scales and adverse effects checklists can be used in clinical practice, research, and quality improvement to incorporate cosmetic patients' perspective in outcome assessments.
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Affiliation(s)
- Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | | | - Jonathan A Schwitzer
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York4Department of Plastic Surgery, Georgetown University Hospital, Washington, DC
| | - Stephen B Baker
- Department of Plastic Surgery, Georgetown University Hospital, Washington, DC
| | - Alastair Carruthers
- Department of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean Carruthers
- Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne Chapas
- Department of Dermatology, New York University School of Medicine, New York, New York
| | - Andrea L Pusic
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Hersant B, Abbou R, SidAhmed-Mezi M, Meningaud JP. Assessment Tools for Facial Rejuvenation Treatment: A Review. Aesthetic Plast Surg 2016; 40:556-65. [PMID: 27178571 DOI: 10.1007/s00266-016-0640-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND In the field of cosmetic medicine, patient satisfaction is an important and common indicator used to measure the efficacy of the treatment. However, it is insufficient to prove objectively that the benefit of the specific factors involved in the cosmetic outcomes. The practitioner should be aware of these assessment tools, in particular in case of demanding or litigious patients. OBJECTIVE The aim of this review was to establish a list and discuss the subjective and objective methods used to assess facial aesthetic rejuvenation treatments. METHODS A systematic literature search was performed using the Pubmed search engine. Studies published over the last 5 years, i.e. between January 2010 and January 2015 were considered for review. The following keywords were used: "aesthetic treatment", "facial rejuvenation", and "subjective evaluation" or "objective evaluation". RESULTS Of the 446 articles identified by the search strategy, 47 articles focused specifically on facial rejuvenation and on the efficacy of aesthetic medical treatments were retrieved for review. Thirty-seven articles used quantitative methods to assess aesthetic treatment outcomes and only 12 used subjective methods. The different assessment methods were listed according to the tools used and treatment indications. CONCLUSION This review will help in choosing adequate methods to assess facial rejuvenation medical treatment. It is important to combine these tools adequately to improve the assessment. There is no current consensus on assess facial rejuvenation treatments but we noted that objective assessment methods seem helpful. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- B Hersant
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France.
| | - R Abbou
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France
| | - M SidAhmed-Mezi
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France
| | - J P Meningaud
- Department of Maxillofacial and Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 avenue du Maréchal de Lattre de Tassigny, Créteil, 94010, France
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Hersant B, SidAhmed-Mezi M, Chossat A, Meningaud JP. Multifractional microablative laser combined with spacially modulated ablative (SMA) technology for facial skin rejuvenation. Lasers Surg Med 2016; 49:78-83. [DOI: 10.1002/lsm.22561] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Barbara Hersant
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillo Facial Surgery; Henri Mondor Hospital; 51 Avenue du Maréchal de Lattre de Tassigny Créteil 94010 France
| | - Mounia SidAhmed-Mezi
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillo Facial Surgery; Henri Mondor Hospital; 51 Avenue du Maréchal de Lattre de Tassigny Créteil 94010 France
| | - Adrien Chossat
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillo Facial Surgery; Henri Mondor Hospital; 51 Avenue du Maréchal de Lattre de Tassigny Créteil 94010 France
| | - Jean Paul Meningaud
- Department of Plastic and Cosmetic Reconstructive Surgery and Maxillo Facial Surgery; Henri Mondor Hospital; 51 Avenue du Maréchal de Lattre de Tassigny Créteil 94010 France
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Chang BL, Wilson AJ, Taglienti AJ, Chang CS, Folsom N, Percec I. Patient Perceived Benefit in Facial Aesthetic Procedures: FACE-Q as a Tool to Study Botulinum Toxin Injection Outcomes. Aesthet Surg J 2016; 36:810-20. [PMID: 26780945 DOI: 10.1093/asj/sjv244] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There are numerous methods of assessing patient satisfaction with botulinum toxin type A neuromodulation of the glabellar rhytids. As the use of aesthetic neuromodulation increases both in breadth and number of procedures, there is a need for more comprehensive tools to evaluate patient-reported outcomes. The FACE-Q is a recently validated patient-reported outcome instrument that can be used to measure patient perceptions of botulinum toxin type A neuromodulation. OBJECTIVES This study used the FACE-Q to assess patient satisfaction following botulinum toxin type A neuromodulation of the glabellar rhytids. METHODS 57 female patients completed the FACE-Q, a survey that evaluates patients' satisfaction with their facial appearance. After this baseline survey, the patients received injections of one of onabotulinumtoxinA (Botox, Allergan, Dublin, Ireland), abobotulinumtoxinA (Dysport, Galderma, Lausanne, Switzerland), or incobotulinumtoxinA (Xeomin, Merz Pharmaceuticals, Frankfurt am Main, Germany) in the glabella. Two weeks post-injection, the patients completed the FACE-Q again. The percentage changes in patient responses were tabulated to determine how neuromodulation affects patient satisfaction with their facial appearance. The percentage changes for each of the neurotoxin groups were compared to determine if patient satisfaction with neuromodulation varies with the type of neurotoxin. RESULTS Patient satisfaction with their overall facial appearance increased by 28% following neuromodulation. Patients stated that they believe they look an average of 5.6 years younger post-neuromodulation. There were no significant differences among the treatment groups. CONCLUSIONS The FACE-Q demonstrates that patients are more satisfied by their overall facial appearance and age appearance following neuromodulation of their glabellar rhytids. Patients are equally satisfied with the improvement of their facial appearance regardless of which neurotoxin they received. LEVEL OF EVIDENCE 2: Therapeutic.
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Affiliation(s)
- Brian L Chang
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Anthony J Wilson
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Anthony J Taglienti
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Catherine S Chang
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Nancy Folsom
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Ivona Percec
- From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA
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La Padula S, Hersant B, SidAhmed M, Niddam J, Meningaud JP. Objective estimation of patient age through a new composite scale for facial aging assessment: The face – Objective assessment scale. J Craniomaxillofac Surg 2016; 44:775-82. [DOI: 10.1016/j.jcms.2016.01.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/02/2016] [Accepted: 01/27/2016] [Indexed: 10/22/2022] Open
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Assessing Patient-Reported Outcomes Following Orthognathic Surgery and Osseous Genioplasty. J Craniofac Surg 2015; 26:2293-8. [DOI: 10.1097/scs.0000000000001983] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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