Continuing Medical Education Information

Target Audience

This activity has been designed to meet the educational needs of plastic surgeons, facial plastic surgeons, ocular plastic surgeons, dermatologists, ophthalmologists, and other physicians who incorporate cosmetic enhancement procedures in their practice.

Statement of Need

The healthcare trend towards patient individualization as a mechanism for outcome optimization has encouraged innovations in injection technique based on anatomy of the facial muscle groups. As new injectable neurotoxins become available, education with regard to efficacy, dosing, safety, and technique is important. This program was designed to reinforce and augment physician understanding of anatomy, proper patient evaluation, injection technique, and understanding of available agents to attain optimal patient outcomes and ensure patient safety and satisfaction.

Educational Objectives

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

Define and differentiate the onset, duration, dosing, and mechanism of action of injectable neurotoxins.
Discuss the efficacy and safety of injectable neurotoxins.
Identify and demonstrate an understanding of facial anatomy, including differences in musculature.
Identify individualized therapy based on anatomic assessment, muscle mass, and gender.
Define the optimal injection techniques for using botulinum neurotoxin type A based on the anatomy of the facial muscle groups.

Accreditation and Credit Designation

Paradigm Medical Communications, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Paradigm Medical Communications, LLC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)TM. 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.

This educational activity is sponsored by Paradigm Medical Communications, LLC, Orangeburg, NY.

Release date: March 31, 2010
Last review date: December 28, 2009
Expiration date: April 1, 2011
Estimated time to complete activity: 1.5 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.
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.

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Faculty and 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.

Steering Committee

Michael A C Kane, MD (Co-Chair); New York, NY
Grant/Research Support: Coapt, Medicis, Revance; Retained Consultant: Allergan, Bioform, Medicis, Mentor, Q-Med, Sanofi-Aventis; Speakers Bureau: Allergan, Medicis, Q-Med, Sanofi-Aventis; Stockholder: Allergan, Medicis.

Gary D Monheit, MD (Co-Chair); Birmingham, AL
Clinical Investigator: Allergan, Colbar LifeScience Ltd-Johnson & Johnson, Contura, Dermik Labs, Electro-Optical Sciences Inc, Galderma, Genzyme, Ipsen/Medicis, Kythera, Revance; Consultant: Allergan, Colbar LifeScience Ltd-Johnson & Johnson, Electro-Optical Sciences Inc, Galderma, Genzyme, Ipsen/Medicis, Mentor, Revance, Stiefel.

Benjamin Ascher, MD (Scientific Reviewer); Paris, France
No financial relationships to disclose.

Vivian W Bucay, MD, FAAD; San Antonio, TX
Speakers Bureau: Allergan, Elemè Medical, Johnson & Johnson, Medicis, Novartis; Advisory Board: Allergan, Aveeno, Medicis.

Lisa M Donofrio, MD, FAAD; New Haven, CT
Grant/Research Support: Allergan, Cynosure, Medicis, Mentor, Merz; Retained Consultant: Medicis, Niadyne, Vichy; Speakers Bureau: Mentor, Vichy; Advisory Board: Medicis.

Julius W Few Jr, MD, FACS; Chicago, IL
Consultant: Allergan, Colbar LifeScience Ltd, Ethicon (pending), Medicis, Merz.

Mark L Jewell, MD; Eugene and Portland, OR
Grant/Research Support: Allergan, Medicis, Mentor; Retained Consultant: Allergan, Liposonix, Medicis; Consultant: AorTech, Coapt Systems, KCI, New Beauty Magazine, Sound Surgical.

Corey S Maas, MD, FACS; San Francisco, CA
Grant/Research Support: Allergan, Colbar LifeScience Ltd, Medicis, Mentor; Retained Consultant: Allergan, Bioform, Johnson & Johnson, Mentor; Speakers Bureau: Allergan, Bioform, Integra LifeSciences, Johnson & Johnson, Lumenis, Medicis; Stockholder: Allergan, Bioform, Johnson & Johnson, Lumenis, Medicis, Mentor.

Berthold Rzany, MD, ScM; Berlin, Germany
Grant/Research Support: Galderma, Merz Pharma, Ipsen Pharma; Retained Consultant: Galderma, Merz Pharma, Ipsen Pharma.

Hema Sundaram, MD, FAAD; Rockville, MD, and Fairfax, VA
Advisor: Promius, SkinMedica; Grant/Research Support: Medicis, Syneron; Retained Consultant: Colbar LifeScience Ltd, Medicis; Speaker: ColoreScience, Medicis, Ortho Dermatologics, Skin Medica, Syneron; Other: Allergan, Senetek, SkinMedica.

Faculty

Jeffrey M Adelglass, MD: No financial relationships to disclose.
Janet Allenby, DO: No financial relationships to disclose.
David J Applebaum, MD: Speakers Bureau: Medicis; Stockholder: Medicis.
David E Bank, MD: Grant/Research Support: Allergan, Medicis; Retained Consultant: Allergan, Colbar, Medicis; Speakers Bureau: Colbar, Medicis.
Lawrence S Bass, MD: Retained Consultant: Bioform, Coapt, Medicis, Palomar Medical Technologies.
Benjamin A Bassichis, MD: Grant/Research Support: Allergan, Dermik, Medicis; Retained Consultant: Genesis Biosystems; Speakers Bureau: Allergan, Dermik, Genesis Biosystems, Medicis.
Leslie Baumann, MD: Grant/Research Support: Galderma; Speakers Bureau: La Roche Posay; Advisory Board: Borba, Medicis, Philosophy, Proctor & Gamble, Stiefel, Vichy.
Brian S Biesman, MD: Grant/Research Support: Cutera, Thermage; Retained Consultant: Lumenis; Speakers Bureau: Thermage.
Gregory A Buford, MD: Speakers Bureau: Allergan, Johnson & Johnson, Lumenis, Sanofi-Aventis.
Kimberly J Butterwick, MD, FAAD: Grant/Research Support: Allergan; Retained Consultant: Dermik, Ortho Dermatologics; Speakers Bureau: Dermik; Other: National Education Faculty, Trainer: Allergan.
Valerie D Callender, MD: Grant/Research Support: Medicis; Retained Consultant: Medicis.
Marc S Cohen, MD: Grant/Research Support: Medicis; Retained Consultant: Allergan, Medicis; Speakers Bureau: Medicis.
Joel L Cohen, MD: Grant/Research Support: Allergan, Biopelle, Medicis, Merz, Obagi, Ortho Dermatologics; Retained Consultant: Allergan, Bioform, Biopelle, Dusa, Medicis, Merz, Obagi, Ortho Dermatologics.
Jody A Comstock, MD: Speakers Bureau: Allergan, Medicis, Obagi; Preceptor: Lumenis. Sue Ellen Cox, MD: Grant/Research Support: Allergan, Coapt, Medicis; Retained Consultant: Allergan, Coapt, Johnson & Johnson, Medicis; Speakers Bureau: Allergan, Coapt, Medicis; Stockholder: Allergan, Medicis.
Steven H Dayan, MD: Grant/Research Support: Allergan, Contura, Medicis, Ortho Dermatologics, PhotoCure.
Jeffrey S Dover, MD, FRCPC: Grant/Research Support: Allergan, Medicis, Merz; Retained Consultant: Medicis, Merz.
Jeanine B Downie, MD: Grant/Research Support: Allergan, Johnson & Johnson, Merz, Stiefel; Retained Consultant: Allergan, Galderma, Johnson & Johnson, Medicis, Skin Medica, Stiefel; Speakers Bureau: Allergan, Galderma, Intendis, Johnson & Johnson, Skin Medica, Stiefel; Stockholder: Allergan: Investigator: Merz, Johnson & Johnson.
Patricia L Farris, MD: Retained Consultant: Beiersdorf, Galderma, Medicis, Neutrogena, Stiefel Labs, Unilever; Royalties: Guthy Renker.
David S Felder, MD: Retained Consultant: Medicis; Stockholder: Medicis.
J Charles Finn, MD: Grant/Research Support: Allergan, Medicis; Retained Consultant: Allergan, Medicis; Speakers Bureau: Allergan, Medicis; Stockholder: Allergan, Medicis.
Ellen C Gendler, MD, FAAD: No financial relationships to disclose.
Dee Anna Glaser, MD: Grant/Research Support: Allergan, Artes; Retained Consultant: Allergan; Speakers Bureau: Ortho Dermatologics; Physician Trainer: Ortho Dermatologics; Advisory Board: Bioform, Dermik.
Michael H Gold, MD: Grant/Research Support: Allergan, Johnson & Johnson, Medicis, Mentor; Retained Consultant: Johnson & Johnson, Medicis, Mentor; Speakers Bureau: Artes, Bioform, Johnson & Johnson, Mentor.
Mitchel P Goldman, MD: Grant/Research Support: Allergan, Medicis, Mentor, Ortho Dermatologics, Sanofi-Aventis; Retained Consultant: Allergan, Medicis, Mentor ,Sanofi-Aventis, Ortho Dermatologics; Speakers Bureau: Ortho Dermatologics, Sanofi-Aventis.
Timothy M Greco, MD: Retained Consultant: Allergan, Medicis; Speakers Bureau: Allergan, Medicis.
Christine A Hamori, MD: No financial relationships to disclose.
C William Hanke, MD, FAAD: Grant/Research Support: Allergan, Graceway, Medicis, Merz; Stockholder: Allergan, Medicis.
Oscar Hevia, MD: Retained Consultant: Bioform.
Haideh H Hirmand, MD: Trainer: Evolence, Johnson & Johnson.
Steven B Hopping, MD: No financial relationships to disclose.
Carolyn I Jacob, MD: Speakers Bureau: Allergan, Medicis; Stockholder: Allergan, Medicis.
John H Joseph, MD: Grant/Research Support: Artes, Isolagen, Glycotex, Medicis; Speakers Bureau: Artes, Medicis, Ortho Dermatologics, Sanofi-Aventis; Stockholder: Artes, Medicis.
Val S Lambros, MD: No financial relationships to disclose.
Z Paul Lorenc, MD: Retained Consultant: Colbar, Ethicon, Medicis.
Stephen H Mandy, MD: Retained Consultant: Proctor & Gamble; Speakers Bureau: Allergan, Ortho Dermatologics; Advisory Board: Stiefel.
Jason Michaels, MD: Speaker: Medicis: Consultant: Allergan, Medicis.
Amir Moradi, MD: Retained Consultant: CAP-MPT Insurance; Speakers Bureau: Allergan, Sciton Lasers, Skin-Medica.
Ronald L Moy, MD: Retained Consultant: Bioform.
Mark S Nestor, MD, PhD, FAAD: Grant/Research Support: Galderma, Medicis, Merz, Neutrogena, Transdermal; Retained Consultant: Galderma, Medicis, Neutrogena, Signum Biosciences, Stiefel Laboratories, Transdermal; Speakers Bureau: Allergan, Galderma, Medicis, Merz, Ortho Dermatologics, Stiefel Laboratories; Advisory Board: Allergan, Medicis, Merz, Ortho Dermatologics, Stiefel Laboratories.
Joseph Niamtu, III, DMD: Speakers Bureau: Allergan, Evolence, Medicis.
Ira D Papel, MD: No financial relationships to disclose.
Malcolm D Paul, MD: Retained Consultant: Angiotech, Invasix; Speakers Bureau: Angiotech, Invasix; Stockholder: Invasix.
Kevin S Pinski, MD: Retained Consultant: Allergan, Bioform, Medicis, Mentor.
Jason N Pozner, MD: Speakers Bureau: Sciton; Advisory Board: Allergan (Clinique), Bioform, Coapt, Sciton.
Rhonda E Rand, MD: Retained Consultant: Artes, Isolagen.
Kent B Remington, MD: Speakers Bureau: Allergan, Clarion (Coherent), Lumenis, Medicis; Advisor: Allergan; Trainer: Clarion (Coherent), Medicis.
Mark G Rubin, MD: Grant/Research Support: Medicis, Suneva; Retained Consultant: Medicis; Stockholder: Medicis.
Joel Schlessinger, MD: Advisory Board/Consultant: Abbott Pharma, Allergan, Amgen, Artes, Dermik, Galderma, Genentech, Glaxo, Health and Wellness Council of America, Kythera, Medicis, Mentor, Merz, MJD Communications, Novartis, Obagi, Ortho Pharma (Johnson & Johnson), Stiefel, TheDerm.org, Vaseline Petroleum Jelly (National Spokesperson, 2000/2001); Researcher: 3M Pharma, Abbott Pharma, Allergan, Amgen, Astellas, Barrier Therapeutics, Biogen, Centocor, Clay-Park Labs, Collagenix, Connetics, Dermik, Dow, ESC Medical, Fujisawa, Galderma, Genentech, Glaxo Pharma, Glenmark Pharma, HealthPoint, Immunex, Ipsen/Inamed, Kythera, Medicis, Mentor, Merz, Novartis, Novum, Nucryst, Ortho Pharma (Johnson & Johnson), Penederm Pharma, Perrigo, Pfizer, QLT USA, Regeneratio Pharma AG, Sandoz, Schering-Plough, Stiefel Labs, UBC/Vitae; Stockholder: Allergan, Excel Cosmeceuticals, Medicis, Mentor, Obagi, TKL Graceway.
Anthony P Sclafani, MD, FACS: Grant/Research Support: Cascade Medical, Contura; Retained Consultant: Cascade Medical; Speakers Bureau: Medicis; Advisory Board: Contura.
Ava T Shamban, MD: Grant/Research Support: Galderma, Medicis, Stiefel; Speakers Bureau: Aesthera, Allergan, Medicis; Stockholder: Allergan, Medicis.
Nancy L Silverberg, MD: Grant/Research Support: Isolagen, Medicis; Stockholder: Isolagen, Medicis.
Stacy R Smith, MD: Retained Consultant: Medicis.
Nowell Solish, MD: Grant/Research Support: Johnson & Johnson, Medicis, Revance; Retained Consultant: Medicis; Speakers Bureau: Allergan, Johnson & Johnson, Medicis, Revance; Stockholder: Revance.
Lori D Stetler, MD: Educational Faculty: Allergan, Bioform; Speakers Bureau: Reliant; Preceptorship: Reliant.
Neil A Swanson, MD: Advisory Board: Stiefel Labs, Graceway, Coria.
Nancy G Swartz, MD: Grant/Research Support: Medicis; Retained Consultant: Allergan, Medicis; Speakers Bureau: Medicis.
Arthur Swift, MD: Grant/Research Support: Medicis; Non-Retained Consultant: Allergan, Johnson & Johnson.
Jonathan M Sykes, MD: Grant/Research Support: Medicis; Retained Consultant: Bioform; Speakers Bureau: Allergan.
Amy F Taub, MD: Grant/Research Support: Allergan, Medicis; Speakers Bureau: Bioform; Stockholder: Medicis; Advisory Board: Medicis.
Susan C Taylor, MD: Grant/Research Support: Allergan, Bioform, Galderma, Johnson & Johnson, Medicis, Quinnora; Speakers Bureau: Allergan, Medicis; Advisory Board: Allergan, Beiersdorf, Johnson & Johnson, Medicis; Owner: T2 for Brown Skin.
Mark B Taylor, MD: Grant/Research Support: Candela, Cynosure, Histogen, Phototherapeutics.
Ruth E Tedaldi, MD: No financial relationships to disclose.
Robert A Weiss, MD: Grant/Research Support: Medicis; Retained Consultant: Medicis; Speakers Bureau: Allergan, Colbar, Johnson & Johnson.
William P Werschler, MD: Grant/Research Support: Allergan, Amgen, Dermik, Galderma, Genentech; Speakers Bureau: Allergan, Bioform, Dermik, Medicis; Stockholder: Allergan, Bioform, Myoscience.
Tina B West, MD: No financial relationships to disclose.
Allan S Wirtzer, MD: Consultant: Aventis, Medicis; Infomercial Appearance: Guthy-Renker.
Carlos L Wolf, MD: No financial relationships to disclose.
Fiona Wright, MD: No financial relationships to disclose.
Allan E Wulc, MD: Stockholder: Apogee LLC; National Education Faculty: Allergan.
Steven G Yoelin, MD: Grant/Research Support: Allergan; Retained Consultant: Allergan, Bioderm, Johnson & Johnson, Medicis, Sanofi-Aventis.

Independent peer reviewers: No financial relationships to disclose.

No Paradigm Medical Communications staff member who was in a position to control or influence the content of this educational activity has a conflict of interest.

Gina Kaeuper, Consulting 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 independent peer review (as in this activity).

This CME Special Report is published by Paradigm Medical Communications, LLC, Orangeburg, NY.

All materials © 2010 Paradigm Medical Communications, LLC, except where noted, and may not be reproduced in whole or in part without the express written permission of Paradigm Medical Communications, LLC.

Signed statements of informed consent granting permission for publication have been obtained for all photographs in which an individual can be identified.

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.

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