Table 1.
Recommended Assessments to Include in a Physical Examination to Ensure Appropriate Patient Selection for ATX-101 Treatment
| • View the patient in the Frankfort plane and have the patient say “E” to engage the platysmal and digastric muscles |
| • Palpate treatable submental fat (SMF), distinguishing it from masses, irregularities, and moderate to severe submandibular glands that mimic SMF and won’t respond to ATX-101 treatment |
| • Determine whether preplatysmal fat is present because it will be associated with better outcomes. With the patient in a neutral position (Frankfort horizontal plane), the physician pinches and palpates the central submentum, then asks the patient to strain the neck (eg, showing lower teeth, saying “E” strongly) while still pinching the submentum. The tissue that easily pulls away when flexing the platysma is both the platysma and subplastysmal fat. The remaining tissue in the hand is skin and subcutaneous fat |
| • Check patient’s smile for asymmetry that may have resulted from marginal mandibular nerve injury following treatment |
| • Evaluate patients for severe submental skin laxity, which may require skin tightening or alternative therapy |
| • Identify long or wide platysmal bands; prominent platysmal bands may require subsequent aesthetic treatment (likely with neuromodulators) to address the exposed platysmal bands once the SMF is reduced. Older patients should be counseled that bands could become more prominent with skeletonization of the muscle during fat reduction |
| • Document position of hyoid bone; if low, injection points for ATX-101 may be more difficult to determine to achieve ideal outcomes because lateral (versus lower) convexity is more easily addressed with ATX-101 treatment |
| • Have patient place tongue on roof of mouth to check for digastric muscle hypertrophy. Patients should be counseled that with both digastric hypertrophy and excess submental fat, the ideal contour may not be achieved although ATX-101 treatment can still be performed |
| • Evaluate for mandibular hypoplasia, which is not ideal for ATX-101 treatment |