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INTRODUCTION

KEY POINTS

  • Individuals of racial minorities underwent 21% of the cosmetic procedures performed in the United States in 2012.

  • Hispanics accounted for 8% of those cosmetic procedures; African Americans, 7%; Asians, 5%; and other non-Caucasians, 2%.

  • Although photodamage is less of a concern in skin of color, all races experience brow furrows, frown lines, and crow’s feet from repeated facial muscle contractions that are amenable to improvement with botulinum toxin.

  • Soft tissue augmentation with dermal fillers is used in the treatment and correction of fine lines, nasolabial folds, marionette lines, tear trough deformities, lip augmentation, volume loss, and acne scars in skin of color patients.

Cosmetic procedures are more popular now than ever before. The American Society for Aesthetic Plastic Surgery (ASAPS) reports that in 2012 alone, surgeons performed over 10 million cosmetic surgical and nonsurgical procedures in the United States.1 The most frequently performed surgical cosmetic procedure was breast augmentation, followed by liposuction, abdominoplasty, eyelid surgery, and rhinoplasty.1 The most popular nonsurgical procedures were botulinum toxin injections, hyaluronic acid fillers, laser hair removal, microdermabrasion, and chemical peels. Over the past few years, the demand for such procedures has grown dramatically. Individuals are seeking cosmetic procedures that are less invasive, more affordable, and with minimal downtime.2 According to the ASAPS, the overall number of procedures performed has increased 250% since 1997.1 This trend is likely to continue as new advances in surgical techniques and materials unfold.

Not only are more people turning to cosmetic dermatology for answers to their cosmetic needs, but also the group of patients who seek cosmetic procedures has become more diverse. In 2012, individuals of racial minorities underwent 21% of the cosmetic procedures performed in the United States. Hispanics accounted for 8% of those procedures; African Americans, 7%; Asians, 5%; and other non-Caucasians, 2%; with the most common minimally invasive procedures being injectable fillers and botulinum toxin type A.1

Skin of color represent the majority of the world and approximately one-third of the U.S. population. The U.S. Census Bureau reported that in the year 2010, the resident population included 38.9 million African Americans, 50.5 million Hispanic Americans, and 15.2 million Asian Americans, Pacific Islanders, and Native Americans.3 The non-Caucasian population in the United States is projected to grow even more in years to come, with the Hispanic population showing the most significant increases.

COSMETIC PROCEDURES

Because skin of color patients have unique cosmetic issues, they seek the procedures that best address their needs. Individuals with skin of color demonstrate less pronounced signs of extrinsic aging (photoaging) when compared with those with lighter-colored skin.4 Additionally, when the signs of photoaging begin to manifest in darker-skinned individuals, it is at a later age. This is largely due to the photoprotective effects of eumelanin in more darkly pigmented skin.5

Intrinsic aging in patients with ...

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