Sue Ellen Cox

BACKGROUND RelabotulinumtoxinA (RelaBoNT-A) is a complex-free, ready-to-use, liquid botulinum toxin A. OBJECTIVE Efficacy/safety of RelaBoNT-A treatment for lateral canthal lines (LCL). METHODS Randomized adults received RelaBoNT-A (30 U/side; n = 230) or placebo ( n = 73) during a 6-month, double-blind, Ph3 study (Relabotulinumtoxin Aesthetic De...

BACKGROUND AbobotulinumtoxinA has become well established as a treatment option for moderate to severe glabellar lines since its first aesthetic approval in 2009. OBJECTIVE Pivotal trials leading to regulatory approval showed that abobotulinumtoxinA treatment was associated with high responder rates when defined as achievement of none or mild glab...

Background A well-defined jawline improves overall facial aesthetics, thus motivating patients to seek jawline augmentation. Objectives This study will evaluate the safety and effectiveness of the hyaluronic acid injectable gel VYC-25L for restoring jawline definition. Methods A US multicenter, evaluator-blinded study randomized adults with grade...

Background Extending the duration of effect of botulinum toxins – by administering doses beyond those of the approved labels – has been an area of increasing interest in the field of aesthetics. Objectives To investigate the safety and duration of effect of 40U prabotulinumtoxinA-xvfs (twice the approved dose and concentration) for the treatment o...

BACKGROUND Hyperfunctional glabellar frown lines can transmit facial miscues that adversely affect emotional communication, increase perceptions of age, and diminish self-esteem. OBJECTIVE To evaluate the efficacy of letibotulinumtoxinA in mitigating the negative psychological impact associated with moderate to severe glabellar lines and to assess...

Background Botulinum toxin type A (BoNT-A) injections continue to be widely used as a common treatment for both males and females. According to a recent survey conducted by the International Society of Plastic Aesthetic Surgeons, the majority of patients receiving these injections are females between the ages 35 and 50. Objectives A post hoc analy...

Beer K, Biesman B, Cox SE, Smith S, Picault L, Trevidic P. Clin Cosmet Investig Dermatol. 2023;16:959–972. The authors advised an inadvertent error at the time of figure assembly led to the selection of incorrect versions of graphs displayed in Figure 1 on page 964 (ie, needle and cannula legends were switched) and Figure 4B on page 965 (ie, incorr...

Background: Despite the absence of Phase III clinical trial data to support their use, 3.4% of all neurotoxin treatments performed internationally for esthetic purposes in 2020 were performed in patients 65 years of age and older. Objectives: To investigate the efficacy and safety of prabotulinumtoxinA for the treatment of moderate to severe gla...

Purpose Cannulas are increasingly used for injecting hyaluronic acid fillers, as they are thought to improve patient comfort safety and treatment tolerability. This study aimed to demonstrate the non-inferiority of a Resilient Hyaluronic Acid 4 (RHA 4) filler injected with a cannula versus a needle for the treatment of moderate to severe nasolabial...

Infraorbital hollows are one of the most common target areas for facial aesthetic treatment; however, they are often perceived to be challenging to treat due to the complex anatomy of the periorbital area, concurrent deformities, and risk of complications. Treatment options include surgical (eg, lower eyelid blepharoplasty with fat transposition or...

Background: OnabotulinumtoxinA safety and efficacy are well established for upper facial lines (UFL), including forehead lines (FHL), glabellar lines (GL), and crow's feet lines (CFL). Objective: To investigate the association of onabotulinumtoxinA efficacy with patient-reported psychological impacts and satisfaction in UFL. Materials and metho...

Background: OnabotulinumtoxinA 20 U reduces glabellar line (GL) severity at maximum frown for ≈3-4 months. Small studies have suggested that >20 U doses may increase efficacy and duration of response for GLs. Objectives: Evaluate safety, pharmacodynamic response, and treatment satisfaction with onabotulinumtoxinA doses ≥20 U for GLs. Methods:...

Background: Studies indicate that the efficacy and durability of a single AbobotulinumtoxinA (ABO) treatment for moderate to severe glabellar lines may be enhanced with increasing dose, while safety outcomes remain consistent with those of the licensed dose (50 U). Aims: Evaluation of subject-reported indicators of treatment efficacy, satisfacti...

Background Letibotulinumtoxin A (Croma Pharma GmbH, Leobendorf, Austria) is a newly manufactured neurotoxin derived from the C. botulinum strain CBFC26. Objectives To assess efficacy and safety of letibotulinumtoxin A in reducing glabellar line severity (GLS) and to evaluate long term safety and efficacy following repeated injections. Methods In...

Background: Using cannulas to deliver facial fillers may reduce adverse events (AEs) compared with needle injection. Objective: To evaluate the safety and effectiveness of VYC-20L (20 mg/mL hyaluronic acid gel with lidocaine) via cannula for midface age-related volume deficit. Materials and methods: This multicenter, evaluator-blind, randomize...

Background For aesthetic treatment with botulinum toxin type A (BoNTA), interest in maximizing treatment duration and efficacy has prompted study of doses higher than those used in registration studies. As data emerge, it is important that physicians understand how to apply study findings to their own practice so that patient demand is satisfied in...

Objective: To evaluate the efficacy and safety of AbobotulinumtoxinA (ABO) dose escalation in the correction of moderate-to-severe glabellar lines. Design: Phase 2, 36-week, multicenter, randomized, dose-ranging, double-blind, placebo-controlled study. Methods: Adults with moderate-to-severe glabellar lines received a single ABO treatment, dos...

Botulinum toxin serotype-A (BoNT-A) preparations are widely used to improve the appearance of wrinkles. While effective and well tolerated, patients require retreatment over time to re-establish the effects. There is growing interest from patients as to whether higher doses can prolong response without significantly increasing side effects. We revi...

Background PrabotulinumtoxinA is a 900-kDa botulinum toxin type A produced by Clostridium botulinum. Objectives The authors sought to investigate the safety of prabotulinumtoxinA for treatment of glabellar lines. Methods This was a multicenter, open-label, repeat-dose, 1-year phase II safety study. Adults with moderate to severe glabellar lines a...

Background: HARK was recently approved in the US for lip augmentation and correction of upper perioral rhytids. Objective: To demonstrate noninferiority of HARK versus a control (HAJV) in lip fullness augmentation at Week 8 after last injection (blinded evaluation). Secondary objectives were to evaluate the effectiveness and safety of HARK in li...

Background: In addition to reducing subcutaneous fat for body contouring, some patients are interested in toning the underlying muscle layer. Objective: This feasibility study evaluated the safety and efficacy of electromagnetic muscle stimulation (EMMS) alone, cryolipolysis alone, and cryolipolysis with EMMS for noninvasive contouring of abdome...

Correction to the supplement, Re-examining the Optimal Use of Neuromodulators and the Changing Landscape: A Consensus Panel Update (J Drugs Dermatol. 2020; 19:4 Supp 1).

Since initial US Food and Drug Administration approval of botulinum toxin type A (BoNT-A) for aesthetic use in 2002, clinical evidence and experience with BoNT-A and understanding of facial anatomy have greatly increased, leading to rapid advances in treatment planning and implementation. BoNT-A use has expanded from the upper face to the midface,...

Since initial US Food and Drug Administration approval of botulinum toxin type A (BoNT-A) for aesthetic use in 2002, clinical evidence and experience with BoNT-A and understanding of facial anatomy have greatly increased, leading to rapid advances in treatment planning and implementation. BoNT-A use has expanded from the upper face to the midface,...

BACKGROUND: ATX-101 (deoxycholic acid) causes adipocytolysis when injected into subcutaneous fat. OBJECTIVE: Evaluate the long-term safety and efficacy of ATX-101 for submental fat (SMF) reduction. METHODS: Adults (N=165) with moderate-to-extreme SMF received ≤6 treatments of open-label ATX-101 (2 mg/cm2) and were evaluated up to 12 months after...

Background: Injectables that behave similarly to native tissue and preserve facial expressiveness represent a new frontier in aesthetic medicine. A range of fillers made of high molecular weight hyaluronic acid (HA) chains with low crosslinking have been specifically developed to complement facial dynamics. Aims: The efficacy and safety of one o...

Facial aging is a multifactorial process that is caused by changes in the skin, fat compartments, and underlying bony elements. Temporary injectable fillers are commonly used to improve the appearance of the aging face by restoring lost volume, smoothing rhytides, reducing skin laxity, and improving facial contouring. These fillers include hyaluron...

Background: Aging of the neck is characterized by changes that include skin dyspigmentation, laxity, rhytides, loss of the mandibular contour, widening of the cervicomental angle, accumulation of submental fat, volume loss and prominence of the platysmal bands. Many cosmetic options exist to address these changes individually, but little literatur...

Lateral canthal lines or crow's feet lines (CFL) may be treated with onabotulinumtoxinA. We identified several key concepts important to understanding the use of onabotulinumtoxinA for treatment of moderate-to-severe CFL. To contextualize and integrate data on the recommended dose and injection patterns of onabotulinumtoxinA for treatment of CFL, w...

Objective: This trial compares the effectiveness and safety of HYC-24L (Juvéderm Ultra XC; Allergan plc, Dublin, Ireland) (24 mg/mL of hyaluronic acid, 0.3% lidocaine) and CPM-22.5 (Belotero Balance; Merz Aesthetics, Raleigh, NC) (22.5 mg/mL of hyaluronic acid) for the treatment of perioral lines. Materials and methods: Men and women aged 35 yea...

Juvéderm Voluma XC is a volumizing hyaluronic acid filler used for correction of age-related midface volume deficit (MVD). The effectiveness of Juvéderm Voluma XC was examined from the patient perspective. Patients with moderate to severe age-related MVD (N = 235) received Juvéderm Voluma XC. At quarterly follow-up visits for 2 years, patients rate...

Patterns of crow's feet lines (CFLs) vary among individuals. To characterize distribution and predictors of CFL patterns. Patterns of CFLs (full fan, lower fan, central fan, and upper fan) were evaluated at maximum smile and at rest from photographs of subjects with moderate-to-severe CFLs. Relationships between CFL pattern and severity, age, gende...

Despite extensive clinical experience with onabotulinumtoxinA, few data exist on patient satisfaction or safety with continuous treatment. This international multicenter study evaluated patient satisfaction and safety with long-term continuous facial aesthetic treatment with onabotulinumtoxinA. Retrospective chart review with a cross-sectional desi...

Importance Common noninvasive to minimally invasive cosmetic dermatologic procedures are widely believed to be safe given the low incidence of reported adverse events, but reliable incidence data regarding adverse event rates are unavailable to date.Objective To assess the incidence of adverse events associated with noninvasive to minimally invas...

BACKGROUND This study was part of a Phase 3 program treating crow's feet lines (CFL) with onabotulinumtoxinA.OBJECTIVE To evaluate the efficacy and safety of onabotulinumtoxinA treatment of CFL.METHODS This multicenter, double-blind, placebo-controlled, 5-month study randomized subjects with moderate-to-severe CFL (maximum smile) to onabotulinumtox...

Background: The efficacy and safety of bimatoprost ophthalmic solution 0.03% for treating hypotrichosis were shown in a randomized controlled trial and in an open-label study. To date, no data on real-world experience have been published. Objective: To evaluate long-term patient satisfaction, usage patterns, and safety of bimatoprost 0.03% in cl...

Many patients seeking rejuvenation treatment have readily apparent age-related changes in facial features. Others exhibit more subtle changes that nonetheless can be corrected to achieve a more youthful appearance. In the following article, four specialists in aesthetic dermatology discuss how injectable hyaluronic acid-based fillers and neurotoxin...

Objective: To examine the effectiveness of a volumizing hyaluronic acid (HA) filler (Allergan, Inc.) from the subject perspective. Methods: Fifteen North American investigational sites used a volumizing HA filler to treat 235 subjects who had moderate to severe age-related mid-face volume deficit. At quarterly follow-up visits for 2 years the sub...

Background: Hypotrichosis of the eyelashes may negatively influence an individual's self-perception and appearance. Assessing the impact of treatment from a patient's perspective may be particularly relevant in trials of aesthetic agents. Once-daily dermal (topically applied) administration of bimatoprost ophthalmic solution 0.03% has been associat...

The use of soft tissue fillers has increased in the last 2 decades. Certain risks accompany the use of soft tissue fillers, including short-term or long-term complications that may be related to injection technique, anatomic location, patient characteristics, or the filler material itself. We present a rare case of facial numbness in the distributi...

Goals/Purpose: The objective was to evaluate efficacy and safety of onabotulinumtoxinA in subjects with lateral canthal rhytids (crow’s feet lines [CFL]). Methods/Technique: This multicenter, double-blind, placebo-controlled, parallel-group, single-treatment study randomized subjects with moderate-to-severe CFL at maximum smile to onabotulinu...

The amount and complexity of scientific and clinical evidence for aesthetic use of botulinum neurotoxin type A (BoNT-A) has expanded rapidly in recent years, especially for abobotulinumtoxinA, necessitating reassessment of current knowledge about aesthetic use of abobotulinumtoxinA and other BoNT-A preparations. A committee of 13 plastic surgeons,...

To assess the effectiveness and safety of small gel particle hyaluronic acid (SGP-HA) for lip augmentation. Adults (n = 180; aged 18-65) scoring 1 (very thin) to 2 (thin) on the 5-point validated Medicis Lip Fullness Scale (MLFS) for the upper or lower lip were randomized (3:1) to SGP-HA (≤1.5 mL/lip) or no treatment. Co-primary effectiveness end p...

Few dosing data on onabotulinumtoxinA to treat hyperdynamic perioral lines (POLs) are available. Studying onabotulinumtoxinA in controlled settings is beneficial to treating a hyperfunctional orbicularis oris. To compare the dose-response relationship of two doses of onabotulinumtoxinA in hyperdynamic POLs. Female subjects (N = 60) received injecti...

All cosmetic injectable products are associated with the risk of both early and delayed complications. Early and expected side effects include swelling, bruising, and erythema at the injection. It is of utmost importance that patients are educated on the treatment they are consenting to receive and the potential risk of these therapies. Side effect...

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...

Bioform Medical provided the materials used in this study.

A new formulation of botulinum neurotoxin type A (BoNTA-ABO; Dysport [abobotulinumtoxinA]; Medicis Aesthetics, Scottsdale, AZ) was recently approved by the US Food and Drug Administration for the treatment of moderate to severe glabellar lines. To assess the long-term safety of repeat administrations of BoNTA-ABO for the treatment of glabellar line...

Sue Ellen Cox, MD, has indicated no significant interest with commercial supporters.

When patients undergoing nonsurgical facial rejuvenation procedures are asked to state their expectations in terms of outcomes, the achievement of a "natural, relaxed look" usually emerges as the paramount goal. The importance to clinicians of delivering on this patient desire is becoming increasingly clear. After all, patient satisfaction is the u...

Global patient-reported outcomes do not evaluate specific aspects of treatment that are important to patients. The objective was to evaluate self-perception of age and specific outcomes that are important to patients receiving botulinum toxin type A or placebo for moderate to severe glabellar lines (using the Facial Line Outcomes Questionnaire to a...

Expanded polytetrafluoroethylene (ePTFE) is a permanent, solid implant that has been used for facial soft tissue augmentation. The implants are generally used in the lower third of the face for filling lips, nasolabial folds, and deeper facial lines. Many physicians have noted complications with this use. To determine physician satisfaction trends...

There has been global neglect of service users' and carers' experiences of dementia care provision in rural areas. The present paper draws on a qualitative study of service provision for people with dementia and their carers in remote and rural Scotland. It draws on interviews with 15 people with dementia and 16 carers to explore their views about...

This study was created by the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement to measure clinical performance and improvement opportunities for physicians and ambulatory health-care organizations. Data were collected prospectively between February 2001 and August 2002. Thirty-nine study centers participated, a...

BACKGROUND: This study was created by the Accreditation Association for Ambulatory Health Care Institute for Quality Improvement to measure clinical performance and improvement opportunities for physicians and ambulatory health-care organizations. Data were collected prospectively between February 2001 and August 2002. Thirty-nine study centers par...

Botulinum toxin type A treatment is a safe and effective treatment for facial lines. Patient satisfaction with treatment has not yet been systematically measured and reported. To create a valid and reliable questionnaire to assess patient satisfaction with facial line treatment and to assess treatment satisfaction in facial line patients. Developme...

The face is the focus of human interactions, and facial appearance profoundly affects self-esteem. Facial appearance is not only a compilation of the dimensions of the primary morphologic features but is also a direct result of the emotional expressions exhibited on the face. Facial expressions are central in the communication of emotions, as well...

The face is the focus of human interactions, and facial appearance profoundly affects self-esteem. Facial appearance is not only a compilation of the dimensions of the primary morphologic features but is also a direct result of the emotional expressions exhibited on the face. Facial expressions are central in the communication of emotions, as well...

Resurfacing techniques have been traditionally limited to the face because of a lack of predictability and standardization for peeling nonfacial skin. There is a need for medical and surgical intervention for treating nonfacial skin that is actinically damaged. Medium-depth chemical peels (Jessner +35% trichloroacetic acid) remove the photodamaged...

Resurfacing techniques have been traditionally limited to the face because of a lack of predictability and standardization for peeling nonfacial skin. There is a need for medical and surgical intervention for treating nonfacial skin that is actinically damaged. Medium-depth chemical peels (Jessner +35% trichloroacetic acid) remove the photodamaged...

Use of high-intensity, high-frequency external ultrasound before liposuction has been reported to enhance the ease of fat extraction, increase the amount of fat extracted, and decrease patient discomfort during liposuction. The purpose of this study was to compare the effect of application of high-intensity continuous wave ultrasound to extremely l...

Melasma can be resistant to topical therapy. Our purpose was to evaluate the efficacy of superficial peels in conjunction with topical tretinoin and hydroquinone in patients with melasma and to evaluate the ability of Wood's light examination to predict response to treatment. We measured increased light reflectance in melasma areas with a colorimet...

Few studies have examined the long-term efficacy of fluorouracil (FU) or chemical peels for the treatment of actinic keratoses (AK). Our earlier work examined the efficacy and safety of a medium-depth chemical peel compared with the standard regimen of topical FU in the treatment of widespread facial AK through 12 months. To determine long-term eff...

Endometrial cancer is the most common gynecologic malignancy. In 1989, the FIGO staging changed from a clinical to a surgical system. Lymphadenectomy for at least some patients has been widely adopted. The risk of extrauterine disease and of treatment failure is predictable, based on factors known preoperatively: 1) tumor histology, 2) tumor grade,...

We compared the efficacy and safety of a medium-depth chemical peel with those of the standard regimen of topical fluorouracil in the treatment of widespread facial actinic keratoses (AK). Fifteen patients with severe facial actinic damage and similar numbers of AK on both sides of the face were treated on the left side with a single application of...

A 5-year-old girl had pemphigus erythematosus based on clinical and immunohistologic criteria. The rare occurrence in childhood of the pemphigus group of disorders, and of pemphigus erythematosus in particular, is discussed. We also review current knowledge concerning the delineation of the different pemphigus subsets and the treatment of pemphigus...

We report a case in which carcinoma erysipeloides was the first sign of the primary malignancy in a patient with a rare form of prostate carcinoma (mixed adenosquamous type) and two cases in which carcinoma erysipeloides was a marker of tumor recurrence in two patients with breast carcinoma. The value of recognizing the distinctive inflammatory man...

Thesis (M.A.)--Texas Technological College, 1961. Includes bibliographical references.