Introduction to Special Topic Fillers and Injectables

December 2013 | Volume 12 | Issue 12 | Editorials | 1329 | Copyright © December 2013

Amy Taub MD

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The December issue of the JDD has so much to offer to the aesthetic and medical dermatologist.
Papers that specifically relate to both fillers and botulinum toxin show that these treatments are entering maturity, as well as being practiced in comprehensive approaches. In addition, many of our international colleagues are contributing to the journal as well as partnering with US colleagues for studies. Having just come back from my second DASIL congress (Dermatologic and Aesthetic Society International League) held in Bangkok in November, I could tell you that it was nothing short of intellectually intoxicating. Although we may not have all specific brands of fillers or toxins available that our colleagues from around the world do, we have much to learn from their creative approach and how they combine treatments in new ways.
Extending the theme of comprehensive international approaches, an internationally recognized aesthetic and cellulite expert, Doris Hexsel, joins with colleagues from South America to gives us two papers demonstrating that using botulinum toxin in a full face approach leads to significant improvement in patient’s quality of life and satisfaction; they also give us the first safety and efficacy study showing similarities and differences between 3 different dosing schemes for incobotulinum toxin.
More than 50 French aesthetic physicians have contributed a consensus paper on the similarities of onabotulinum toxin and incobotulinum toxin. There has been an ongoing debate at meetings about whether there are substantial differences between the available Botulinum A preparations and this paper will add a very significant voice(s) to that conversation.
Wendy Roberts takes the comprehensive approach one step farther and discusses her approach to generational dermatology, or taking care of your patients needs over 2 decades or more. I see this in my practice as I age with my patients. They look to me to help them keep their face and body looking how they feel. The younger patients come in wanting to maintain what they have. It is our job to guide them on their journey, and Dr. Roberts will help us realize and rethink this.
This issue also includes an evaluation of the neck. Debby Sarnoff, a well-known New York dermatologist, did a solo evaluation of a new 1440 nm laser with a unique side-firing fiber for neck tightening and fat reduction. She got great results with minimal adverse events in 24 patients without performing any liposuction.
Even if you aren’t an aesthetic aficionado, you can still enjoy this issue. There are two papers on new topical formulations for formulas. Remember when we thought ointments were the best vehicles for thick plaques? Sprays have changed our thought processes, especially as they also help immensely with compliance, an ongoing everyday frustration for the general dermatologist. Leon Kircik and colleagues have evaluated a desoximetasone .25% spray that has been formulated to reduce stratum corneum irritation and be super potent at the same time. Steven Feldman and colleagues have shown that clobetasol proprionate spray can diminish signs and symptoms of psoriasis in one week and that this correlates with effectiveness at week 4.
In the one paper that gives me pause, Diane Thibotout and esteemed international acne experts call on us to prescribe fewer antibiotics for acne, due to concerns over increasing bacterial resistance. How can we keep our patients clear without them? We are all going to have to really lobby our insurance carriers to pay for blue and red light as well as photodynamic therapy, or put a lot more people on isotretinoin. Yes, retinoids and benzoyl peroxides