Richard G Glogau

Publications (15)29.15 Total impact

• Article: Safety and tolerability of high-intensity focused ultrasonography for noninvasive body sculpting: 24-week data from a randomized, sham-controlled study.

  Mark L Jewell, Robert A Weiss, Richard A Baxter, Sue Ellen Cox, Jeffrey S Dover, Lisa M Donofrio, Richard G Glogau, Michael C Kane, Patrick Martin, Ira D Lawrence, Joel Schlessinger
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  ABSTRACT: High-intensity focused ultrasonography (HIFU) is a nonsurgical, noninvasive method for body sculpting in nonobese patients. The technique ablates subcutaneous adipose tissue by causing molecular vibrations that increase tissue temperature and induce rapid cell necrosis. The authors evaluate the long-term safety of a HIFU device for sculpting the abdomen and flanks. Adults with subcutaneous abdominal fat ≥2.5 cm in thickness who met screening criteria were randomized to receive HIFU treatment of the anterior abdomen and flanks at 1 of 3 energy levels (3 passes per patient): 47 J/cm(2) (141 J/cm(2) total), 59 J/cm(2) (177 J/cm(2) total), or 0 J/cm(2) (no energy applied; sham control). Safety was assessed for 24 weeks and included laboratory testing, physical examinations, and documentation of adverse events. Adverse events (AE) included mild to moderate discomfort, ecchymosis, and edema, all of which were transient. There were no reports of scarring or burns and no clinically meaningful changes in lipid panel findings, inflammatory markers, or renal or hepatic function. Physical examination results were unremarkable. Conclusions: This HIFU device exhibited an AE profile similar to that of sham treatment. There were no significant changes from baseline in laboratory values, including lipid levels.
  Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery 09/2012; 32(7):868-76.
• Article: Fillers: from the past to the future.

  Richard G Glogau
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  ABSTRACT: Modern medical use of injectable soft-tissue augmentation fillers has evolved from the introduction of bovine collage implants to an array of synthesized materials in the current domestic and foreign markets. The concept of augmentation has moved from simple lines, scars, and wrinkles to revolumizing the aging face. A brief overview of the past, present, and future injectable fillers is presented.
  Seminars in cutaneous medicine and surgery 06/2012; 31(2):78-87. · 1.81 Impact Factor
• Article: Development and validation of a new clinically-meaningful rating scale for measuring lateral canthal line severity.

  Michael A Kane, Andrew Blitzer, Fredric S Brandt, Richard G Glogau, Gary D Monheit, Rhoda S Narins, Jean A Paty, Jacob M Waugh
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  ABSTRACT: Several scales have been employed for evaluating the effects of cosmetic treatments in the periorbital area. The Food and Drug Administration (FDA) has recently issued new recommendations specifying a rigorous process to validate new aesthetic scales. The authors describe and validate a new clinical rating scale: the Investigator's Global Assessment of Lateral Canthal Line (IGA-LCL) severity scale. The new FDA recommendations were utilized to validate the new scale. The first step was concept elicitation (based on direct input from clinicians, patients, and literature) and evaluation of content validity (appropriateness of concepts). The resulting five-point scale provided detailed descriptions of the lateral canthal lines (LCL), including quantitative assessment of LCL length and depth. Performance parameters, including intra- and interrater reproducibility and construct validity, were then evaluated in clinical studies. Finally, the scale's threshold for clinically-meaningful benefit and the ability of the scale to detect change were confirmed in two Phase 2b clinical studies involving a total of 270 subjects. Content validity was established and the IGA-LCL scale showed excellent interrater reliability (weighted Kappa = 0.89) and interrater reliability (weighted Kappa = 0.77; Kendall's coefficient of concordance = 0.89). In clinical trials, the scale was sensitive enough to detect clinically-meaningful one- and two-point changes in LCL severity following treatment with topical botulinum toxin type A (BoNT-A). The authors observed statistically-significant correlations between the physician-rated IGA-LCL results and patient-reported outcomes. The IGA-LCL scale was shown to be reliable, appropriate, and clinically meaningful for measuring LCL severity.
  Aesthetic surgery journal / the American Society for Aesthetic Plastic surgery 03/2012; 32(3):275-85.
• Article: Randomized sham-controlled trial to evaluate the safety and effectiveness of a high-intensity focused ultrasound device for noninvasive body sculpting.

  Mark L Jewell, Richard A Baxter, Sue Ellen Cox, Lisa M Donofrio, Jeffrey S Dover, Richard G Glogau, Michael A Kane, Robert A Weiss, Patrick Martin, Joel Schlessinger
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  ABSTRACT: High-intensity focused ultrasound presents a noninvasive approach to body sculpting for nonobese patients. The purpose of this study was to evaluate the safety and effectiveness of a high-intensity focused ultrasound device for sculpting of the abdomen and flanks. Adults (aged 18 to 65 years) with subcutaneous abdominal fat greater than or equal to 2.5 cm thick who met screening criteria were randomized to receive high-intensity focused ultrasound treatment of the anterior abdomen and flanks at energy levels (a total of three passes each) of 47 J/cm (141 J/cm total), 59 J/cm (177 J/cm), or 0 J/cm (no energy applied, sham control). The primary endpoint was change from baseline waist circumference at the iliac crest level at posttreatment week 12. Subjective aesthetic assessments included the Global Aesthetic Improvement Scale and a patient satisfaction questionnaire. Safety assessments included adverse events, laboratory values, and physical examinations. For the primary endpoint, in the intent-to-treat population, statistical significance versus sham was achieved for the 59-J/cm (-2.44; p = 0.01) but not the 47-J/cm treatment group (-2.06 cm; p = 0.13). In a per-protocol population, statistical significance versus sham was achieved for both the 59-J/cm (-2.52 cm; p = 0.002) and the 47-J/cm treatment groups (-2.10 cm; p = 0.04). Investigator subjective measures of global aesthetic improvement and patient satisfaction also favored each active treatment versus sham. Adverse events included mild to moderate discomfort, bruising, and edema. Laboratory values and physical examinations were unremarkable. Treatment with this high-intensity focused ultrasound device reduced waist circumference and was generally well tolerated for noninvasive body sculpting. Reduction in waist circumference was statistically significant with both active treatments (per protocol). Therapeutic, II.(Figure is included in full-text article.).
  Plastic and reconstructive surgery 07/2011; 128(1):253-62. · 2.74 Impact Factor
• Article: The successful treatment of Schamberg's disease with the 595 nm vascular laser.

  Renée A D'Ambrosia, Vidya S Rajpara, Richard G Glogau
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  ABSTRACT: The authors have indicated no significant interest with commercial supporters.
  Dermatologic Surgery 11/2010; 37(1):100-1. · 1.80 Impact Factor
• Article: Recommendations and treatment options for nodules and other filler complications.

  Rhoda S Narins, William P Coleman, Richard G Glogau
  Dermatologic Surgery 10/2009; 35 Suppl 2:1667-71. · 1.80 Impact Factor
• Article: The efficacy and safety of a new U.S. Botulinum toxin type A in the retreatment of glabellar lines following open-label treatment.

  Mark G Rubin, Jeffrey Dover, Richard G Glogau, David J Goldberg, Mitchel P Goldman, Joel Schlessinger
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  ABSTRACT: A new U.S. Botulinum toxin type A (BoNT-A) has been shown to be safe and effective when administered once, but there is a paucity of clinical evidence regarding long-term use. To evaluate the long-term efficacy and tolerability of repeated treatment with BoNT-A in the correction of moderate-to-severe glabellar lines. STUDY DESIGN/METHODOLOGY: Multicenter, phase 3, randomized, placebo-controlled, double-blind study comparing the efficacy of BoNT-A (50 units) with placebo upon re-treatment of glabellar lines following two-to-three cycles of open-label BoNT-A treatment in 311 patients. At endpoint, BoNT-A produced a significantly higher proportion of responders versus placebo. The incidence of treatment-emergent adverse effects (TEAEs) was slightly lower during additional treatment cycles; the frequency was comparable between BoNT-A and placebo groups. Multiple treatment cycles of BoNT-A were well tolerated in the majority of patients, and there was no tachyphylaxis seen during the study duration of up to 23 months.
  Journal of drugs in dermatology: JDD 06/2009; 8(5):439-44. · 1.57 Impact Factor
• Article: Effect of injection techniques on the rate of local adverse events in patients implanted with nonanimal hyaluronic acid gel dermal fillers.

  Richard G Glogau, Michael A C Kane
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  ABSTRACT: One question associated with dermal fillers is whether the rate and variability of local adverse events following treatment are related to injection technique and needle trauma or to the intrinsic chemical composition. The objective was to determine if there is a relationship between dermal filler injection technique and the incidence of local adverse events. A prospective, blinded, controlled study enrolled 283 patients who were randomized to receive midface volume correction of the nasolabial folds and oral commissures with the nonanimal-stabilized hyaluronic acid (NASHA) gel filler Restylane or Perlane (Medicis Pharmaceutical Corp.). Data were collected on multiple injection technique variables to assess adverse events. Injection techniques that increase the dissection of the subepidermal plane (e.g., fanlike needle use, rapid injection, rapid flow rates, and higher volumes) increased the incidence of local adverse events. Injection techniques that increase epidermal damage or subcutaneous exposure (e.g., multiple punctures or deep subcutaneous injection) had no effect on adverse events. Furthermore, single injection correction, depth of injection, and NASHA product injected had no effect on local adverse events. Local adverse events following injection with the NASHA gel fillers used in this study were related to investigator technique and not to differences in the intrinsic properties of the NASHA agents.
  Dermatologic Surgery 07/2008; 34 Suppl 1:S105-9. · 1.80 Impact Factor
• Source

  Available from: upmc.edu

  Article: Advances in facial rejuvenation: botulinum toxin type a, hyaluronic acid dermal fillers, and combination therapies--consensus recommendations.

  Jean D A Carruthers, Richard G Glogau, Andrew Blitzer
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  ABSTRACT: Facial aesthetics and rejuvenation are evolving rapidly due to changes in products, procedures, and patient demographics. Clinicians can benefit from ongoing guidance on products, tailoring treatments to individual patients, treating multiple facial areas, and using combinations of products and ways to optimize outcomes. A multidisciplinary group of aesthetic treatment experts convened to review the properties and uses of botulinum toxin type A (BoNTA) and hyaluronic acid fillers and to update consensus recommendations for facial rejuvenation using these two types of products. The group considered paradigm shifts in facial aesthetics; optimal techniques for using BoNTA and hyaluronic acid fillers alone and in combination; the influence of patient sex, ethnicity, cultural ideals, and skin color on treatment; general techniques; patient education and counseling; and emerging trends and needs in facial rejuvenation. The group provided specific recommendations by facial area, focusing on relaxing musculature, restoring volume, and recontouring using BoNTA and hyaluronic acid fillers alone and in combination. For the upper face, BoNTA remains the cornerstone of treatment, with hyaluronic acid fillers used to augment results. These fillers are central to the midface because of the need to restore volume. BoNTA and hyaluronic acid in combination can improve outcomes in the lower face. Optimal outcomes in facial aesthetics require in-depth knowledge of facial aging and anatomy, an appreciation that rejuvenation is a three-dimensional process involving muscle control, volume restoration, and recontouring, and thorough knowledge of properties and techniques specific to each product in the armamentarium.
  Plastic and reconstructive surgery 06/2008; 121(5 Suppl):5S-30S; quiz 31S-36S. · 2.74 Impact Factor
• Source

  Available from: internationalhyperhidrosissociety.us

  Article: Topically applied botulinum toxin type A for the treatment of primary axillary hyperhidrosis: results of a randomized, blinded, vehicle-controlled study.

  Richard G Glogau
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  ABSTRACT: The objective was to demonstrate that botulinum toxin type A (BTX-A) can be delivered to targeted skin sites with topical application for the treatment of primary axillary hyperhidrosis. This randomized, blinded, vehicle-controlled study enrolled 12 patients with primary axillary hyperhidrosis with greater than 50 mg of sweat produced per 5 minutes. BTX-A (200 U), combined with a proprietary transport peptide molecule to bind the toxin in a noncovalent manner, was topically applied to one axilla; vehicle without BTX-A was applied to the other axilla. Rates of sweat production were measured and imaged at baseline and 4 weeks after application. Two patients were excluded from analyses. At 4 weeks, 10 axillae treated topically with BTX-A demonstrated a 65.3+/-21.5% mean reduction in sweating relative to the same-patient, vehicle-control axillae, which had a 25.3+/-66.2% mean reduction. The 40% difference in mean sweat reduction between groups was statistically significant (p<.05). Quantitative image analysis of the results of the Minor's iodine starch test confirmed the reduction of sweat production in the BTX-A-treated versus the vehicle-treated axillae. Topically applied BTX-A appears to be safe and may prove to be effective for the treatment of axillary hyperhidrosis.
  Dermatologic Surgery 02/2007; 33(1 Spec No.):S76-80. · 1.80 Impact Factor
• Article: A quality rating scale for aesthetic surgical procedures.

  Murad Alam, Jean DesJardin, Kenneth A Arndt, Jeffrey S Dover, Robert M Hodapp, Leslie Baumann, Harold J Brody, Jean B Carruthers, William P Coleman, Jerome M Garden, [......], Richard G Glogau, Carolyn I Jacob, Bruce E Katz, Arnold William Klein, Madeline C Krauss, Naomi Lawrence, Ronald L Moy, Rhoda S Narins, Neil S Sadick, Michael S Kaminer
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  ABSTRACT: Cosmetic dermatologic procedures offer the promise of visible aesthetic enhancement with minimal risk. While in recent years the number of available procedures has proliferated, there are few objective methods for evaluating the relative quality of these procedures for particular indications or specific patients. (A) To develop a simple, easy-to-use numerical rating scale to assess the quality of cosmetic surgical procedures on a range of parameters pertaining to clinical efficacy and patient satisfaction; (B) to statistically validate the discriminative value of this rating scale. (A) Patient and physician interviews were performed to elicit a list of factors that may collectively characterize the clinical efficacy and patient tolerability of cosmetic dermatologic procedures. A 0-100 point rating scale was developed based on these factors, with the face-validity of this scale checked by a group of patients and physicians; (B) Statistical analysis of the questionnaire was performed by asking 15 expert cosmetic dermatologic surgeons to use it to rate 23 common cosmetic dermatologic procedures, and analyzing the results. (A) An easy-to-use scale was constructed to assess the quality of cosmetic dermatologic procedures by rating the associated cost, risk, time (procedure and recovery), discomfort, results, and longevity of benefit. A "physician adjustment factor" was used to further increase the relevance of this 0-100 point scale for specific patients; (B) Repeated-measures analysis of variations (ANOVAs) performed on the data from the survey of experts demonstrated that this scale can be used to discriminate between common dermatologic procedures. The differences in mean subscores and total scores among procedures grouped by anatomic site and target lesion-type were significant at the level of P < .05. Patient preferences exogenous to the rating scale may increase or decrease the suitability of specific procedures. Common cosmetic dermatologic procedures are of uniformly high quality, as per expert ratings on a systematic measure. This quality rating scale appears statistically valid and robust, given that expert raters assigned similar ratings to the same procedures but mean ratings were different across procedures. In the future, this quality rating scale can be used to assess novel interventions, and to help dermatologic surgeons faced with patient concern to optimally select among alternative procedures for a given indication.
  Journal of the American Academy of Dermatology 02/2006; 54(2):272-81. · 3.99 Impact Factor
• Article: Safety and efficacy of nonanimal stabilized hyaluronic acid for improvement of mouth corners.

  Jean Carruthers, Arnold W Klein, Alastair Carruthers, Richard G Glogau, Douglas Canfield
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  ABSTRACT: Esthetic concern with downturned mouth corners ("mouth frown") is increasing in the aging baby-boomer generation. A new technique to offer structural support using the recently approved filler nonanimal stabilized hyaluronic acid (NASHA; Restylane, Q-med Inc., Uppsala, Sweden) is described. Fifteen women with prominent downturned mouth corners met the inclusion criteria for the study. All were photographed before and at 1 week, 3 months, 4.5 months, and 6 months after treatment using a standardized clinical photographic system. NASHA was injected using a standardized technique with nerve block anesthesia to ensure patient comfort. All 15 women noted swelling, redness, and some local discomfort for several days after the injection. All noted an improvement in the downward angulation of their mouth corners at the first post-treatment visit, with at least partial improvement maintained through the 6-month post-treatment follow-up visit. NASHA injection to support the age-related downturn of lateral lip corners was effective, safe, and well tolerated in a small prospective study of middle-aged female subjects. Esthetic satisfaction was greatest in the first 3 months post-treatment, but 40% of subjects still noted improvement at the 6-month follow-up visit.
  Dermatologic Surgery 04/2005; 31(3):276-80. · 1.80 Impact Factor
• Article: Treatment of hyperhidrosis with botulinum toxin.

  Richard G Glogau
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  ABSTRACT: Focal idiopathic and episodic eccrine sweating of the axillae, palms, soles, and face troubles afflicted individuals with a social curse that can only be imagined by those whose hands or underarms dampen only occasionally. Although there is no accurate incidence in the epidemiology literature, it seems that about half of the patients who have presented to the author with this condition have at least one first-degree relative similarly affected. Social stigma, lack of understanding on the part of medical providers as to the cause and nature of the problem, and lack of effective therapy keeps most of these patients from seeking medical care. This article investigates the treatment of hyperhidrosis with botulinum toxin.
  Dermatologic Clinics 05/2004; 22(2):177-85, vii. · 2.16 Impact Factor
• Article: Hyperhidrosis and botulinum toxin A: patient selection and techniques.

  Richard G Glogau
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  ABSTRACT: Focal idiopathic excessive eccrine sweating presents most commonly as an affliction of three anatomically distinct area: the axillae, the palms and soles, and the upper face. The true incidence is not known, but about half of the patients referred to us with this condition have at least one first-degree relative similarly affected. Only a fraction of patients afflicted are thought to seek medical care because of the social stigma, lack of understanding on the part of medical providers as to the cause and nature of the problem, and, until now, lack of effective nonsurgical therapy. A large social sample is required to accurately measure both the incidence and the exact nature of the genetic influence.
  Clinics in Dermatology 22(1):45-52. · 2.33 Impact Factor
• Article: Review of the use of botulinum toxin for hyperhidrosis and cosmetic purposes.

  Richard G Glogau
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  ABSTRACT: This article reviews the current status of dermatological uses for botulinum toxin type A (Botox), recently approved in the United States for treatment of glabellar wrinkles, and type B (Myobloc), approved for cervical dystonia. The respective formulations of Botox and Myobloc are described, and injection techniques and special considerations for administration in the treatment of dermatologic conditions are also discussed. The use of botulinum toxin injections for cosmetic treatment of movement-related facial lines and platysmal bands in the neck is reviewed, including injection procedures, efficacy, and potential complications. Recent developments in the use of botulinum toxins for the treatment of palmar and axillary hyperhidrosis are also described, comparing type A and type B results. Although direct comparisons between botulinum toxins for dermatologic applications are complicated by the lack of functional equivalence of the standard potency assays, appropriate dosing strategies for obtaining satisfactory clinical results using type B are being established, which will add to the experience already gained with type A. The diffusion characteristics of type B appear to show different and potentially advantageous clinical profiles in the treatment of crows' feet and hyperhidrosis compared with type A.
  Clinical Journal of Pain 18(6 Suppl):S191-7. · 2.81 Impact Factor