A single-center, dose-comparison, pilot study of botulinum neurotoxin type A in female patients with upper facial rhytids: Safety and efficacy

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Treating multiple upper facial rhytids at one time is common, but has not been researched extensively.


We sought to compare the safety, efficacy, and effect duration of 3 botulinum neurotoxin type A (BoNTA) doses in treating multiple upper facial rhytids.


Sixty women, randomized to 32, 64, or 96 U total doses, were assessed at baseline, week 2, week 4, then every 4 weeks. The primary efficacy measure was proportion of responders on the patient global assessment of improvement. Adverse events (AEs) were monitored.


All BoNTA doses were effective and safe. Significant between-group differences occurred in the percentage of responders (96 U: 71%, 64 U: 61%, 32 U: 26%; P = .0007). Adverse events did not differ significantly among groups; no serious treatment-related adverse events occurred.


BoNTA doses were fixed and not tailored to individuals.


These results confirm the efficacy and safety of 3 doses of BoNTA for treating upper facial rhytids in female patients; higher doses afforded greater benefit.

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