【 文献重点摘要 】
 

Background

Botulinum toxin type A injection remains the leading nonsurgical cosmetic procedure worldwide, with a high rate of efficacy and patient satisfaction.

Methods

A multinational, multidisciplinary group of plastic surgeons and dermatologists convened the Global Aesthetics Consensus Group to develop updated consensus recommendations with a worldwide perspective for botulinum toxin and hyaluronic acid fillers. This publication on botulinum toxin type A considers advances in facial analysis, injection techniques, and avoidance and management of complications.

Results

Use of botulinum toxin has evolved from the upper face to also encompass the lower face, neck, and midface. The Global Aesthetics Consensus Group emphasizes an integrative, diagnostic approach. Injection dosage and placement are based on analysis of target muscles in the context of adjacent ones and associated soft and hard tissues. The indication for selection of botulinum toxin as a primary intervention is that excessive muscular contraction is the primary etiology of the facial disharmony to be addressed. Global Aesthetics Consensus Group recommendations demonstrate a paradigm shift toward neuromodulation rather than paralysis, including lower dosing of the upper face, more frequent combination treatment with hyaluronic acid fillers, and intracutaneous injection where indicated to limit depth and degree of action.

Conclusions

The accumulation of clinical evidence and experience with botulinum toxin has led to refinements in treatment planning and implementation. The Global Aesthetics Consensus Group advocates an etiology-driven, patient-tailored approach, to enable achievement of optimal efficacy and safety in patient populations that are rapidly diversifying with respect to ethnicity, gender, and age.

背景

A型肉毒毒素注射剂仍然是全球领先的非手术美容手术，具有很高的有效率和患者满意度。

方法

一个由整形外科医生和皮肤科医生组成的多国多学科小组召集了全球美学共识小组，从世界范围内对肉毒杆菌毒素和透明质酸填充物提出最新的共识建议。这本关于A型肉毒毒素的出版物讨论了面部分析、注射技术以及并发症的避免和管理方面的进展。

结果

肉毒杆菌毒素的使用已经从上面部进化到包括下面部、颈部和中面部。全球美学共识小组强调一种综合的、诊断性的方法。注射剂量和位置基于对邻近肌肉和相关软硬组织的目标肌肉的分析。选择肉毒杆菌毒素作为主要干预措施的适应症是肌肉过度收缩是面部不和谐的主要原因需要解决。全球美学共识小组的建议显示了向神经调节而不是瘫痪的范式转变，包括降低上面部剂量，更频繁地与透明质酸填充物联合治疗，以及在显示限制作用深度和程度的情况下皮内注射。

结论

肉毒杆菌毒素的临床证据和经验的积累导致了治疗计划和实施的改进。全球美学共识小组倡导病因学驱动的、患者量身定做的方法，以实现在种族、性别和年龄方面迅速多样化的患者群体中实现最佳疗效和安全性。