Commentary on: Botulinum Toxin to Improve Lower Blepharoplasty Scar: A Double-Blinded, Randomized, Vehicle-Controlled Clinical Trial.

Abstract

It is rare and refreshing to see a prospective double-blind, placebo-controlled study in aesthetic surgery. To some extent this is due to the nature of our field and the practical and ethical constraints that prevent randomizing or blinding treatments in cosmetic surgical patients. However, the authors of “Botulinum Toxin to Improve Lower Blepharoplasty Scar: A Double-Blinded, Randomized, Vehicle-Controlled Clinical Trial” 1 have accomplished this task quite cleverly. As the authors have pointed out, the benefit of botulinum toxin A (BoNT-A) injection in scar healing for keloid scar revision has been shown in previous studies,2 and in their own prior study on cleft lip revision scars.3 One difference between these prior studies and the current one is that the earlier studies address scars in locations that have already been shown to be hypertrophied at least in part because of muscle action tending to pull perpendicular to the scar or...