Understanding the African American facial aesthetic patient
Presenters: Boyd C1, Alexis A2, Callender V3, Downie J4, Shumate GT5, Gallagher CJ5
Affiliations: 1BOYD, Birmingham, MI; 2Icahn School of Medicine at Mount Sinai, New York, NY; 3Callender Dermatology and Cosmetic Center, Glenn Dale, MD; 4Image Dermatology, Montclair, NJ; 5Allergan plc, Irvine, CA
Background/Objective: Aesthetic injectors might perceive challenges when addressing the aesthetic needs of African American patients. Understanding the anatomical considerations, facial aging patterns, aesthetic concerns, and treatment preferences might increase the comfort level for the injector and improve outcomes for African American patients. Injectors should also consider any patient misconceptions (e.g., keloid scarring) associated with injection procedures. Accordingly, clinical case studies can provide practical examples of how to implement this knowledge during patient consultation, assessment, and treatment. Two studies were performed to gain insights into self-reported facial aging characteristics and treatment considerations among African American patients.
Methods: Eight-hundred and fifty-nine African American men (145) and women (714) completed an online evaluation in which they assessed their facial features against photonumeric scales depicting degrees of severity for 10 facial characteristics. Four-hundred and one African American women completed a separate online evaluation to identify areas of aesthetic concern, relative prioritization of treatment areas, and attitudes toward injectable treatments. Respondents for both evaluations were naïve to facial aesthetic treatments. A subsequent meeting of experts with significant experience in treating African American patients produced case studies to illustrate the translation of these data to the clinical setting.
Results: In the African American population, moderate-to-severe signs of facial aging were not generally reported until 50 to 79 years of age. At ages 70 to 79 years, over 70 percent were still without moderate-to-severe perioral lines, loss of lip fullness, or midface volume loss. The majority reported having uneven skin tone/color (57%) and dark circles under the eyes (48%). African American patients were most bothered by their tear trough and submental regions. Areas most likely to be prioritized for treatment included tear trough, submental region, and horizontal forehead lines. In contrast, African American patients were less likely to prioritize treatment of perioral lines, lips, temples, and cheeks. African American women reported the lowest consideration rate for injectables (64%), compared to Asian or Hispanic individuals. “Looking good for their age” was the top reason for considering aesthetic treatment, but the cost, perceived safety, and side effects were the largest barriers. Clinical case studies demonstrated practical treatment strategies utilizing commercially available facial aesthetic products.
Conclusion: Across the two research studies, self-reported facial aging characteristics correlated with bothersome areas; both tear trough treatment and submental fat reduction could be seen as entry points for facial aesthetic injectables for this population. An understanding of these objective research findings and practical case studies might increase the comfort level for an injector and improve outcomes for African American patients.