Heterogeneous crow's feet line patterns and customized botulinum toxin rejuvenating treatment.
Botulinum toxin
Crow's feet lines
canthal rhytids
onabotulinumtoxin A
Journal
Journal of cosmetic dermatology
ISSN: 1473-2165
Titre abrégé: J Cosmet Dermatol
Pays: England
ID NLM: 101130964
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
revised:
17
05
2022
received:
08
02
2022
accepted:
14
06
2022
pubmed:
21
6
2022
medline:
3
11
2022
entrez:
20
6
2022
Statut:
ppublish
Résumé
From early dynamic lines in smiling and squinting young people, crow's feet lines in the lateral canthal region evolve through prolonged tissue remodeling into mature, stable rhytids after the mid-to-late thirties, and requests for rejuvenating treatment. Because of the heterogeneous fanning behavior of crow's feet lines, individualizing neuromodulation with botulinum toxin injections might be a sound strategy to maximize aesthetic outcomes. To investigate the prevalence of variable crow's feet line patterns at maximum contracture and while smiling and comment on the relative distribution of such patterns and the influence of aging. These considerations will be the basis and rationale for future studies that will individualize the total 24-unit dose according to the distribution of crow's feet lines. Identifying CFL orientation at maximum frown and while smiling; assessment tool: the four-class 2015-version of Kane's classification further modified by converting the former "central fan pattern" into a new, more precisely defined "extended full-fan pattern" class. The 323 cohort subjects had a mean age of 51.5 ± 9.28 years. Although with some differences, outcomes in a central-southern real-world European Caucasian population appear similar to the distribution first studied in 2003 in a highly selected population in New England involved in double-blind clinical trials. The full-fan pattern predominated both at maximum contraction and when smiling, followed in prevalence by the upper-fan pattern at maximum contraction and the extended full-fan pattern while smiling. Age significantly influenced the crow's feet line pattern-lower-fan patterns were more frequent than other patterns in the real-world younger middle-age group (40-49 years old); full-fan and extended full-fan patterns progressively more prevalent with aging. The study confirms but somewhat modifies the previous evidence about the non-homogeneous distribution of crow's feet line fanning patterns in different age groups and reinforces the case to individualize the topography of botulinum toxin injections.
Sections du résumé
BACKGROUND
BACKGROUND
From early dynamic lines in smiling and squinting young people, crow's feet lines in the lateral canthal region evolve through prolonged tissue remodeling into mature, stable rhytids after the mid-to-late thirties, and requests for rejuvenating treatment. Because of the heterogeneous fanning behavior of crow's feet lines, individualizing neuromodulation with botulinum toxin injections might be a sound strategy to maximize aesthetic outcomes.
AIMS
OBJECTIVE
To investigate the prevalence of variable crow's feet line patterns at maximum contracture and while smiling and comment on the relative distribution of such patterns and the influence of aging. These considerations will be the basis and rationale for future studies that will individualize the total 24-unit dose according to the distribution of crow's feet lines.
METHODS
METHODS
Identifying CFL orientation at maximum frown and while smiling; assessment tool: the four-class 2015-version of Kane's classification further modified by converting the former "central fan pattern" into a new, more precisely defined "extended full-fan pattern" class.
RESULTS
RESULTS
The 323 cohort subjects had a mean age of 51.5 ± 9.28 years. Although with some differences, outcomes in a central-southern real-world European Caucasian population appear similar to the distribution first studied in 2003 in a highly selected population in New England involved in double-blind clinical trials. The full-fan pattern predominated both at maximum contraction and when smiling, followed in prevalence by the upper-fan pattern at maximum contraction and the extended full-fan pattern while smiling. Age significantly influenced the crow's feet line pattern-lower-fan patterns were more frequent than other patterns in the real-world younger middle-age group (40-49 years old); full-fan and extended full-fan patterns progressively more prevalent with aging.
CONCLUSIONS
CONCLUSIONS
The study confirms but somewhat modifies the previous evidence about the non-homogeneous distribution of crow's feet line fanning patterns in different age groups and reinforces the case to individualize the topography of botulinum toxin injections.
Substances chimiques
Botulinum Toxins, Type A
EC 3.4.24.69
Neuromuscular Agents
0
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4294-4300Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Narurkar V, Shamban A, Sissins P, Stonehouse A, Gallagher C. Facial treatment preferences in aesthetically aware women. Dermatol Surg. 2015;41(Suppl 1):S153-S160. doi:10.1097/DSS.0000000000000293
Kane MAC. Classification of crow's feet patterns among Caucasian women: the key to individualizing treatment. Plast Reconstr Surg. 2003;112(5 Suppl):33S-39S. doi:10.1097/01.PRS.0000082192.45787.B6
Kane MAC, Cox SE, Jones D, Lei X, Gallagher CJ. Heterogeneity of crow's feet line patterns in clinical trial subjects. Dermatol Surg. 2015;41(4):447-456. doi:10.1097/DSS.0000000000000336
Watanabe K, Loukas M. In: Watanabe K, Shoja MM, Loukas M, Tubbs RS, eds. Anatomy for Plastic Surgery of the Face, Head, and Neck. 1st ed. Thieme Medical Publishers, Inc.; 2016.
OnabotulinumtoxinA Prescribing Information. https://www.accessdata.fda.gov›drugsatfda_docs (accessed: March 24, 2022).
Moers-Carpi M, Carruthers J, Fagien S, et al. Efficacy and safety of onabotulinumtoxinA for treating crow's feet lines alone or in combination with glabellar lines: a multicenter, randomized, controlled trial. Dermatol Surg. 2015;41(1):102-112. doi:10.1097/DSS.0000000000000220
Lowe NJ, Lask G, Yamauchi P, Moore D. Bilateral, double-blind, randomized comparison of 3 doses of botulinum toxin type A and placebo in patients with crow's feet. J Am Acad Dermatol. 2002;47(6):834-840. doi:10.1067/mjd.2002.124070
Baumann L, Dayan S, Connolly S, et al. Duration of clinical efficacy of onabotulinumtoxinA in crow's feet lines: results from two multicenter, randomized, controlled trials. Dermatol Surg. 2016;42(5):598-607. doi:10.1097/DSS.0000000000000757
Carruthers A, Bruce S, Cox SE, Kane MAC, Lee E, Gallagher CJ. OnabotulinumtoxinA for treatment of moderate to severe crow's feet lines: a review. Aesthet Surg J. 2016;36(5):591-597. doi:10.1093/asj/sjw025
Carruthers A, Bruce S, de Coninck A, et al. Efficacy and safety of onabotulinumtoxinA for the treatment of crow's feet lines: a multicenter, randomized, controlled trial. Dermatol Surg. 2014;40(11):1181-1190. doi:10.1097/DSS.0000000000000128
BOTOX 100 Units - Summary of Product Characteristics (SmPC). https://www.medicines.org.uk/emc/medicine/112#gref. Accessed on December 18, 2021.
Wu Y, Wang G, Li C, Mao C, Lei X, Lee E. Safety and efficacy of onabotulinumtoxinA for treatment of crow's feet lines in Chinese subjects. Plast Reconstr Surg Glob Open. 2019;7(1):e2079. doi:10.1097/GOX.0000000000002079
Connell BF, Marten TJ. Surgical correction of the crow's feet deformity. Clin Plast Surg. 1993;20(2):295-302.
Morrow DM. Chemical peeling of eyelids and periorbital area. J Dermatol Surg Oncol. 1992;18(2):102-110. doi:10.1111/j.1524-4725.1992.tb02441.x
Carruthers JD, Carruthers JA. Treatment of glabellar frown lines with C. botulinum A exotoxin. J Dermatol Surg Oncol. 1992;18(1):17-21. doi:10.1111/j.1524-4725.1992.tb03295.x
Ye P, Feng X-L, Yang Z-H, et al. The anatomy of the temporal and zygomatic branches of the facial nerve: application to crow's feet wrinkles. J Craniofac Surg. 2021;32(3):878-882. doi:10.1097/SCS.0000000000007123