# A Decade in Focus: Examining Lessons Learned From Office-Directed Injectables in an Academic Practice

## TL;DR

This study analyzes trends and safety of botulinum toxin and filler injections over 10 years in an academic practice, showing low complication rates and patient crossover to surgery.

## Contribution

The study provides a longitudinal analysis of injectable trends, patient demographics, and complications in an academic setting over a decade.

## Key findings

- Injectable cases increased over time, except in 2020, with botulinum toxin being the most common treatment.
- Complications were rare, with 35 from botulinum toxin and 33 from fillers across 5794 cases.
- Nineteen percent of injectable patients later received aesthetic surgery, while 0.6% of surgery patients later received injectables.

## Abstract

Noninvasive facial rejuvenation procedures have continued to grow in popularity, with botulinum toxin and injectable soft-tissue fillers being the most common.

The purpose of this study was to evaluate trends in patient cost, provider product preferences, and complications of a single surgeon's 10-year experience with botulinum toxin and soft-tissue fillers. Additionally, this study aimed to quantify the crossover between patients receiving injectables and patients receiving aesthetic surgery.

This was a retrospective analysis utilizing internal/departmental records and Epic charting from January 2013 to January 2023. Botulinum toxin and soft-tissue filler cases were captured using select CPT codes, and patient demographics, complications, and follow-up data were recorded.

One thousand three hundred and sixty-eight patients undergoing 5794 injectable cases were assessed. The study population was majority female (89.3%) and Caucasian (78.7%). Injectable cases increased over time, except for a decrease in 2020. Botulinum toxin was most common (59%), followed by fillers (18%), and combination therapy (19%). Common injection sites included the glabella, crow's feet, and forehead for neurotoxins and marionette lines and nasolabial folds for fillers. Complications were rare, with 35 from botulinum toxin and 33 from fillers. Of patients receiving injectables, 19.6% went on to receive an aesthetic surgery, and 0.6% of patients undergoing aesthetic surgery subsequently received injectables.

Botulinum toxin and soft-tissue fillers are safe with low complication rates when administered by an experienced provider. These procedures may serve as a starting point for patients pursuing antiaging treatments and an opportunity to establish continuity of care for providers.