• Intended Audience
• Statement of Need
• Learning Objectives
• Faculty
• Agenda
• Accreditation and Certification
• Disclosure
• Additional Content Planners
• Acknowledgement
• Privacy Statement
• Registration, Evaluation, Post-Test, and Certificate Request Forms
• Internet Privacy Information
• Copyright Policy

Intended Audience

This activity was developed for dermatologists and plastic surgeons who use BoNTA in facial cosmetic enhancements.

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Statement of Need

The popularity of cosmetic procedures has exploded in the last decade. According to a published report from the American Society for Aesthetic Plastic Surgery (ASAPS), some 11.7 million cosmetic procedures were performed in the United States in 2007 at a cost of roughly $13.2 billion. In the United States, injection of BoNTA has become the most common nonsurgical cosmetic procedure.

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Since 2001, there has been only one FDA-approved BoNTA formulation available for commercial use for facial aesthetics in the United States. A Biologic License Application of a different BoNTA (abobotulinumtoxinA) was recently approved by the FDA and will be available soon. This formulation has been available in other parts of the world for many years, and some non-US physicians have considerable expertise in its use for facial aesthetics. While the approval of a new BoNTA in the United States will offer clinicians and their patients another option for the optimal treatment for facial enhancement, it also poses a number of challenges. Specifically, different formulations of BoNTA appear to possess different scientific and clinical properties, which affect reconstitution, dosing, injection technique, efficacy (onset and duration), and field of effect. Moreover, additional BoNTA formulations are available in other parts of the world; some are in clinical development in the United States and are expected to be marketed in the next few years. For these reasons, practitioners must be well informed about the use of different BoNTA products to ensure the best possible results and patient satisfaction. To this end, there is a need for education that focuses on an understanding of the musculature of the face, differences in patient characteristics that can affect treatment, proper injection techniques, and practice pearls from experienced practitioners.

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Learning Objectives

Upon completion of this activity, participants should be able to:

1. Summarize the key findings from clinical trials of BoNTAs in facial aesthetics
2. Understand the dose range for abobotulinumtoxinA and how to individualize dosing based on patient characteristics and desires
3. Explain the main similarities and differences between BoNTA formulations, including dosing, reconstitution and storage, injection techniques, field of effect, and onset and duration of action
4. Identify common muscles in the face for BoNTA injection

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Faculty

Lisa Donofrio, MD, Co-Chair
Associate Clinical Professor of Dermatology, Yale University School of Medicine
Private Practice, The Savin Center for Dermatology and Cosmetic Surgery

New Haven, Connecticut, USA

Michael Kane, MD, Co-Chair
Plastic Surgeon, Private Practice
New York, New York, USA

Benjamin Ascher, MD
Plastic Surgeon, Lecturer, and Clinical Assistant, Paris V Academy
Director, Clinique of Aesthetic Surgery IENA
Founder and Scientific Director, IMCAS Congress
Paris, France

Doris Hexsel, MD
Formerly Professor of Dermatology at the University Passo Findo, Brazil
Head Investigator, Brazilian Center for Studies in Dermatology
Private Practice, Hexsel Dermatology Clinic

Porto Alegre and Rio de Janeiro, Brazil

Gary Monheit, MD
Associate Clinical Professor, Departments of Dermatology and Ophthalmology
University of Alabama Medical Center
Private Practice, Total Skin and Beauty Dermatology Center, PC

Birmingham, Alabama, USA

Berthold Rzany, MD, ScM
Head of the Division of Evidence-Based Medicine, Department of Dermatology
Charité-Universitätsmedizin

Berlin, Germany

Robert Weiss, MD
Director, Maryland Skin and Vein Institute
Associate Professor, Johns Hopkins University School of Medicine

Baltimore, Maryland, USA

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Agenda

On February 7 and 8, 2009, a group of experts in the aesthetic use of BoNTA from around the world came together to develop consensus statements on the use of the new BoNTA formulation. The goals of this meeting were to discuss the latest information regarding the knowledge and gaps in BoNTA neurotoxin science (ie, mechanism of action, pharmacokinetics, etc); review and summarize the available clinical data on the new BoNTA formulation; share personal experiences with the use of BoNTA in clinical practice; and develop consensus on the optimal use of BoNTA for facial aesthetics for physicians with little to no experience with the product.

This activity presents the highlights of the meeting in the form of a roundtable discussion with some of the consensus attendees, in which they review top-line findings and discussion points from the consensus meeting.

This activity will address professional practice gaps in knowledge and competence.

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Accreditation and Certification

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Annenberg Center for Health Sciences at Eisenhower and Signature Business Solution, LLC. The Annenberg Center is accredited by the ACCME to provide continuing medical education for physicians.

The Annenberg Center designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Disclosure

It is the policy of the Annenberg Center to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty and planners participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationship with those supporting the activity or any others whose products or services are discussed.

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Additional Content Planners

Karen Bickford, Jacqueline Bailey, PharmD, Toni Nouri, RPh, Robert Rullo, and Christina Wright have nothing to disclose.

All staff at the Annenberg Center for Health Sciences at Eisenhower have nothing to disclose.

The faculty for this activity has disclosed that there will be discussion about the use of products for non-FDA approved indications.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of the Annenberg Center and/or its agents. As in all educational activities, we encourage practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient’s unique clinical situation. The Annenberg Center disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.

This activity is an enduring material and consists of a Web activity. Successful completion is achieved by reading and viewing the material, reflecting on its implications in your practice, and completing the assessment component.

The estimated time to complete the activity is 1 hour.

This was originally released in August 2009 and is eligible for credit through August 2010.

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Acknowledgement

This activity is supported by an independent educational grant from Medicis Pharmaceutical Corporation.

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Privacy Statement

Signature Business Solution, LLC, respects your privacy. We don't share information you give us, or have the need to share this information in the normal course of providing the services and information you may request. If there should be a need or request to share this information, we will do so only with your explicit permission.

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Registration, Evaluation, Post-Test, and Certificate Request Forms

Registration for educational programs or conferences typically requires some personal information necessary to issue a Continuing Education certificate.  This information is required regardless of the method used to register. Personal data collected for this purpose is not shared with others except as required to complete payment or provide the requested certificate. Aggregate data about registrations and certificates issued may be shared with faculty, supporting organizations, or others, but individual identifying information is not included in these data sets.

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Internet Privacy Information

For more information about privacy online, cookies, and what a Web server can and cannot learn about you without your cooperation, visit the Center for Democracy and Technology's Privacy page at: http://www.cdt.org/privacy/.

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Copyright Policy

Signature Business Solution, LLC, owns the copyright for, or has received permissions for use of, or is otherwise permitted to use copyrighted materials within this CE activity.You may not modify copy, reproduce, republish, upload, post, transmit, or distribute in any way any material from this Web site, including code and software. You may use material from this site for your personal, noncommercial use only, provided you keep intact all copyright and other proprietary notices.

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