NASHA Fillers: A Consensus on Persistence and Use in Special Patient Populations

Target Audience

Plastic Surgeons and Dermatologists

Statement of Need

Recent advances in facial soft tissue augmentation technology have resulted in improved persistence, less potential for infl ammatory or antigenic reactions, a more natural appearance, and easier administration. The continuing pursuit of longer-lasting facial fillers, spurred by patient demand, has led to the introduction of a variety of products with varying clinical characteristics. Attempts to understand how their similarities and differences translate to actual variations in outcome have been confounded by differences in clinical trial design. This publication explores these issues, describing pertinent research, and discusses the potential value of these products in several special populations including persons of color, those with photodamaged skin, HIV-positive individuals with facial lipoatrophy, and men.

Educational Objectives

Upon proper completion of this CME activity, participants should be able to:

Evaluate the long-term efficacy and safety of nonanimal stabilized hyaluronic acid (NASHA) facial fillers
List benefits of extending the persistency of NASHA facial fillers
Describe strategies to extend NASHA persistency
Discuss current and potential uses of NASHA facial fillers in persons of color, in those with photodamaged skin, in those with HIV lipoatrophy, and in men

Accreditation and Credit Designation

Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the ACCME by Paradigm Medical Communications, LLC. Paradigm Medical Communications, LLC designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Each physician should claim only those credits commensurate with the extent of his or her participation in the activity.

This activity is supported by an educational grant from Medicis Pharmaceutical Corporation.

Release date: December 2008
Last review date: November 2008
Expiration date: December 31, 2010
Estimated time to complete activity: 2.0 hours

Instructions for Participation

To receive a CME certificate of participation, participants should:

Read the entire publication, including the Continuing Medical Education Information
Complete the posttest questions and evaluation form on pages 14 and 15 and mail or fax the evaluation form with answer key to Paradigm Medical Communications, 523 Rt. 303, Orangeburg, NY 10962; Fax: 845-398-5108.
A certificate of participation will be issued 4 to 6 weeks after receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.

Faculty Disclosures

In accordance with ACCME requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in this activity.

Michael A.C. Kane, MD
Kane Plastic Surgery
New York, NY
Associate Attending Surgeon
Manhattan Eye, Ear, and Throat Hospital
New York, NY
Grant/Research Support: Medicis Pharmaceutical Corporation
Speakers� Bureau: Allergan, Inc; Medicis Pharmaceutical Corporation; Sanofi-Aventis
Retained Consultant: Allergan, Inc; BioForm Medical, Inc; Medicis Pharmaceutical Corporation; Sanofi-Aventis
Stockholder: Allergan, Inc; Medicis Pharmaceutical Corporation

Richard G. Glogau, MD
Clinical Professor of Dermatology
University of California, San Francisco
San Francisco, CA
Retained Consultant: Allergan, Inc; FibroGen, Inc; Liposonix, Inc;
Medicis Pharmaceutical Corporation; Revance, Inc
Investigator: Allergan, Inc; Contura, Inc; Liposonix, Inc;
Medicis Pharmaceutical Corporation; Revance, Inc

Hayes B. Gladstone, MD
Peer-Reviewer
Director, Division of Dermatologic Surgery
Associate Professor
Stanford University Medical Center
Stanford, CA
Retained Consultant: Bioform Medical, Inc

David Mjolsness
Account Executive, Paradigm Medical Communications, Orangeburg, NY
No financial relationships to disclose

Denise Frontin
Senior Program Director, Paradigm Medical Communications, Orangeburg, NY
No financial relationships to disclose

Nancy J. Lucas
Editor, Paradigm Medical Communications, Orangeburg, NY
No financial relationships to disclose

Malcolm Hall
Contributing Editor
No financial relationships to disclose

Resolution of Conflict of Interest

Paradigm Medical Communications, LLC has implemented a system to resolve conflicts of interest for each continuing medical education activity to help ensure content objectivity, independence, fair balance, and that the content is aligned with the interest of the public. Conflicts, if any, are resolved through one or more processes, including peer review.

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Although this activity is no longer certified for credit, we believe that it contains important information and hope you'll review, print or email it to a colleague.

This newsletter is published by Paradigm Medical Communications, LLC, Orangeburg, NY.

This CME activity represents the views and opinions of the individual faculty, and does not constitute the opinion or endorsement of, or promotion by, Paradigm Medical Communications, LLC. Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.