Abstract
AbobotulinumtoxinA (aboBoNT-A) has been used for various cosmetic purposes, including minimization of moderate to severe lines, or other cosmetic indications, in the face and neck. We carried out a systematic review to identify all relevant evidence on the treatment approaches and outcomes of aboBoNT-A as a cosmetic treatment of the middle and lower areas of the face, and the neck. Embase, MEDLINE, Cochrane Library, congress proceedings and review bibliographies were searched for relevant studies. Identified articles were screened against pre-specified eligibility criteria. Of 560 unique articles identified, 10 were included for data extraction (three observational studies, 1 randomized controlled trial [with two articles] and five non-randomized trials). The articles provided data on gummy/asymmetric smile (2), marionette lines (5), masseter muscle volume (2), nasal wrinkles (2), perioral wrinkles (3) and the platysma muscle (4). All articles reporting on efficacy of aboBoNT-A demonstrated positive results, including reduction of wrinkles (5), reduction of masseter muscle (2) and degree of gummy smile (1) compared with before treatment. No serious adverse events were reported and patient satisfaction was high. In conclusion, positive findings support further research of aboBoNT-A for the middle and lower areas of the face, and in the neck, which are largely unapproved indications.
Highlights
Botulinum neurotoxin type-A injections are currently the most popular type of cosmetic procedure worldwide [1,2,3,4]
It is approved in many other countries worldwide for glabellar lines and other aesthetic indications, it is common for physicians to use aboBoNT-A to treat wrinkles and lines in other areas of the face and neck [14,15]
A total of 625 papers were identified in the electronic database searches; 65 duplicate papers were excluded before citation screening and 510 papers were excluded during citation screening (Figure 1)
Summary
Botulinum neurotoxin type-A injections are currently the most popular type of cosmetic procedure worldwide [1,2,3,4]. In the EU, it is indicated (Azzalure 125 unit vial) for the temporary improvement in the appearance of moderate to severe glabellar lines seen at frown and/or lateral canthal lines seen at maximum smile, in adult patients less than 65 years, when the severity of these lines has an important effect on the psychological well-being of the patient [13] It is approved in many other countries worldwide for glabellar lines and other aesthetic indications, it is common for physicians to use aboBoNT-A to treat wrinkles and lines in other areas of the face and neck [14,15]. These recommendations provide information on the number and location of the injection points, the dose of individual injection points, the combined dose of multiple injection points, the injection technique and safety concerns for each area [4,14,16,17]
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