In this week's edition
- ✍️ Letter from P'Fella
Behind the 'Fella: Season 2 is coming! - 🤓 The Sunday Quiz
How well do you know Botox? - 🖼️ Image of the Week
Initial Botox experiments on monkeys in 1973. - 🚑 Technique Tip
Tip on Botox injection for horizontal lines. - 📋 Featured Article of the Week
Welcoming a new fellow with an article feature! - 📖 What Does the Evidence Say
How long does Botox actually last? - 🔥 Articles of the Week
Can Botox cause Botulism?, Botox for finger replants, & use of Botox in plastics: with 1 sentence summaries. - 💕 Feedback
Suggest ideas & give feedback!
A Letter from P'Fella
Behind the 'Fella: Season 2 is Coming!
After experimenting with different formats and ideas in Season 1 of Behind the Fella, we’re ready to take things up a notch. Season 2 is here, and it’s going to be bigger, sharper, and packed with practical takeaways.
No fluff. No "why medicine" chatter. Just actionable insights from legit experts in plastic surgery — people at the top of their game, ready to share what works in the OR and beyond.
What’s New in Season 2?
This season is designed for passive learning on the go — perfect for your morning commute or a quick break between cases. Here’s a sneak peek at what we’re bringing to the table:
- Expert Interviews: From the cutting edge of penis replantation and reconstruction to using intraoperative ultrasound for better flap outcomes, these aren’t just conversations; they’re masterclasses.
- No-Nonsense Takeaways: Every episode will leave you with something tangible — tips, techniques, or ideas you can apply directly to your practice.
Here’s a Sneak Peek 👇
We Need Your Input!
We just wrapped an incredible episode on penis replantation with a global leader in the field. Next up, we’re diving into ultrasound-guided flap optimization. But we want to hear from you! If you work with an expert you think the community would benefit from hearing, let us know. We’ll reach out (no pressure or commitment required).
This season is all about creating something valuable for you — the plastic surgery community. Your suggestions will help shape it.
P'Fella ❤️
The Sunday Quiz
How Well Do You Know Botox?
Welcome to the next round of The Weekly Quiz.
Each edition of thePlasticsPaper includes a quiz question designed to challenge and engage our readers. Keep your wits about you and join in every week — the winner at the end of six rounds will earn you a one-year subscription to thePlasticsPro.
Image of the Week
Botox on Monkeys in 1973
In this section, we feature an anatomical illustration. This week, we’re spotlighting a study that takes us back to the early research days of botulinum toxin. The image shows its experimental use on monkeys in 1973.
Technique Tip
Botox Injection for Horizontal Lines
This week’s technique focuses on the treatment of horizontal lines using onabotulinumtoxinA. Injections are made at five key sites, with the option of targeting two additional sites (indicated by circles) (left).
- Needle Depth: Asterisks mark the one-third needle depth for each injection.
- Injection Method: Gently pinch the skin until a papule forms. Insert the needle at an upward angle to one-third of its depth (right).
Featured Article of the Week
Welcoming One of Our New Fellows!
We’re thrilled to announce that Dr. Benedetta Agnelli will be soon joining our team as our newest fellow, from Milan 🇮🇹
To kick things off, Benedetta has contributed her very first article on Botulinum Toxin — a must-read for anyone interested in the nuances of botox in both aesthetic and functional procedures. Read below for an overview.
Botulinum Toxin
BoNT, derived from Clostridium botulinum, temporarily relaxes muscles by inhibiting acetylcholine release, offering diverse therapeutic and cosmetic applications.
With popular brands like Botox® and Dysport®, it’s used to treat migraines, hyperhidrosis, and wrinkles. Precise injection techniques and tailored dosing are key, though contraindications like pregnancy and rare side effects must be considered.
Learn more about everything Botox 👇
What Does the Evidence Say?
How Long Does Botox Actually Last?
A meta-analysis reported a median duration of 120–131 days for glabellar lines (Glogau et al., 2012) and 93–95 days for cervical dystonia, with higher doses (≥180 U) prolonging effects (Marsh et al., 2014).
AbobotulinumtoxinA shows onset within 2–3 days, lasting 3–6 months (Nestor et al., 2020). Variability underscores the need for individualized treatment plans and further research (Wright et al., 2018; Smith et al., 2018).
Articles of the Week
3 Interesting Articles with 1 Sentence Summaries
Cosmetic injection-induced botulism presents neuromuscular symptoms, often within 48 hours, with treatment including botulinum antitoxin and supportive therapy.
Botulinum toxin type A improves blood flow and pain in ischemic hand trauma, achieving 100% digit salvage in cases of early vascular compromise, supporting its use as standard therapy.
Botulinum neurotoxin addresses aging signs and medical conditions in plastic surgery, with key uses including rhytides, dystonias, hyperhidrosis, and spasticity.
