Journal of Clinical and Aesthetic Dermatology

AUG 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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16 JCAD journAl oF clinicAl And Aesthetic derMAtologY august 2017 • Volume 10 • number 8 16 I b AcKground. the demand for minimally invasive aesthetic procedures has driven requests by physicians for guidance on their use in asian patients, who have unique cultural preferences, social trends, and anatomy. however, few guidelines exist, particularly on combination treatment strategies for different facial shapes or indications such as the modification of face shapes to the "oval ideal." physicians must, therefore, apply caucasian patient-optimized guidelines to their asian patients. Methods. eleven specialists developed a consensus on the use of botulinum toxin a (Bont-a), calcium hydroxylapatite (caha) and hyaluronic acid (ha) fillers, and microfocused ultrasound with visualization (MfU-V) devices in asian patients on upper-, middle-, and lower-face indications, including strategies to modify different facial shapes to the oval shape. approval from 70 to 90 percent of all participants led to moderate consensus, while 90 percent agreement denoted a strong consensus. results. for early intervention/enhancement and restoration, most combination strategies are similar between asian and caucasian patients. compared to caucasian patients, however, beautification is a more common focus in asian patients. the "ideal" oval facial shape can be created using different interventions depending on the patient's baseline characteristics. conclusions. although treatments and treatment sequences for early intervention/ enhancement and restoration for beautification in asian patients are similar to those in caucasian patients, different treatment strategies may be required. KeY words: asian, consensus guidelines, combination treatment, fillers, botulinum toxin a B s t r a c t c o n s e n s U s pAnAAsiAn consensus— Key recommendations for adapting the World congress of dermatology consensus on combination treatment with Injectable fillers, toxins, and Ultrasound devices in asian patients by YAtes Y.Y. chAo, Md; chirAnjiv chhAbrA, Mbbs, dvd; niAMh corduFF, Mbbs, FrAcs; sAbrinA guillen FAbi, Md; MArtinA Kerscher, Md; stephAnie c.K. lAM, Mbchb; tAtjAnA pAvicic, Md; berthold rzAnY, Md, scM; peter h.l. peng, Md; AtchiMA suwAnchindA, Md; FAngAwen tseng, Md; and KYle K. seo, Md, phd dr. chao is with chao and chiu Institute of dermatology, taipei, taiwan; dr. chhabra is with skin alive clinic, new delhi, India; dr. corduff is with cosmetic refinement clinic, Geelong, australia; dr. fabi is with cosmetic laser dermatology, san diego, california, Usa; dr. Kerscher is with University of hamburg, hamburg, Germany; dr. lam is with central health Medical practice, hong Kong; dr. pavicic is in private practice for dermatology and aesthetics, Munich, Germany; dr. rzany is with rZany & hUnd, Berlin, Germany; dr. peng is with p-skin professional clinic, Kaohsiung, taiwan; dr. suwanchinda is with Medisci Biointegrative and antiaging and cosmetic Medical center, Bangkok, thailand; dr. tseng is with Milano aesthetic clinic, taipei, taiwan; and dr. seo is with seoul national University college of Medicine and Modelo clinic, seoul, Korea. J Clin Aesthet Dermatol. 2017;10(7):16–27 Funding: no funding was provided for this study. disclosures: drs. Kerscher, lam, peng, suwanchinda, and tseng have no conflicts of interest relevant to the contents of this article. dr. rzany is a speaker and/or advisor for Ipsen and its affiliates, Galderma and Merz. dr. chhabra has no . dr. seo is a clinical investigator and/or consultant for allergan, Merz pharmaceuticals, Q-Med/Galderma, Medytox, lG life sciences, and daewoong. dr. corduff is a speaker/advisor for Merz, Motiva, and spiran. dr. fabi is a speaker, consultant, and investigator for Galderma, Merz, allergan, and Valeant and is an investigator for revance. dr. pavicic is a speaker and/or advisor for Merz, Galderma, cynosure, eucerin, dermaceutic, and Ipsen. dr. chao is a speaker and/or advisor for Galderma, Merz, and Valeant. Author correspondence: yates chao; email: In order for physIcIans to effIcIently deliver optimal patient outcomes, contemporary aesthetic medicine now requires the harmonious combination of multiple aesthetic therapies. current guidelines with instructive recommendations on the application of combination treatments focus predominantly on caucasian patients. 1–3 few such guidelines are available for asian patients; therefore, physicians must apply recommendations optimized for caucasian anatomies and aesthetic goals to asian patients. asian patients seek aesthetic intervention at a younger age, compared to caucasians, 4 and their requests typically focus on early intervention/ enhancement, beautification, 5 and the correction of facial deficits. 6 In comparison, caucasian patients typically seek restorative interventions for more severe, age-related problems. physicians are inevitably faced with the challenge of effectively

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