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Repeated Botulinum Toxin A Injections for the Treatment of Lines in the Upper Face: A Retrospective Study of 4,103 Treatments in 945 Patients
Authors:BERTHOLD RZANY,MD,SCM,,DOROTHEE DILL-MÜ  LLER,MD,,DORIS GRABLOWITZ,MD,,MARC HECKMANN,MD,, DAVID CAIRD,PHD,,ON BEHALF OF THE GERMAN&ndash  AUSTRIAN RETROSPECTIVE STUDY GROUP
Affiliation:Division of Evidence Based Medicine, Department of Dermatology, CharitéUniversitätsmedizin, Berlin, Germany;;Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany;;Dermatologisch-Medizinisch-Ästhetisches Zentrum, Vienna, Austria;;Hautzentrum am Starnberger See, Starnberg, Germany;;Medical Department, Ipsen Pharma GmbH, Ettlingen, Germany
Abstract:BACKGROUND Although botulinum toxin type A (BoNT-A) is a common aesthetic intervention, there are few published data on treatment over more than two cycles.
OBJECTIVE To evaluate the effectiveness/safety of repeated doses of BoNT-A (Dysport, Ipsen Ltd., Slough, UK) in the upper face for reduction of wrinkles.
METHODS Retrospective, cross-sectional patient chart review from 945 patients who had received a minimum of three consecutive, documented treatment cycles.
RESULTS The glabella was treated most frequently (93.9%), with the majority (81.5%) of patients receiving treatment in more than one area of the face. BoNT-A treatments were combined with other aesthetic procedures in 57.5% of cases, mostly with fillers (37.1%). There was no evidence of tachyphylaxia: the dose applied, the interval between treatments, and satisfaction with the results remained stable over the course of treatment. Adverse events were those expected with BoNT-A treatment (most common: local bruising and ptosis) and were all mild or moderate in intensity. There was no sign of any cumulative adverse effects: indeed, the adverse-event rate decreased in later treatment cycles.
CONCLUSIONS Long-term, repeated injections of BoNT-A for corrections of wrinkles in the upper face yield a continuously high level of safety and effectiveness in actual practice.
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