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Effects of Botulinum Toxin on Improving Facial Surgical Scars: A Prospective, Split-Scar, Double-Blind, Randomized Controlled Trial

Hu, Li, Ph.D., M.D.; Zou, Yun, M.D.; Chang, Shih-Jen, M.D.; Qiu, Yajing, M.D.; Chen, Hui, Ph.D., M.D.; Gang, Ma, Ph.D., M.D.; Jin, Yunbo, Ph.D., M.D.; Lin, Xiaoxi, Ph.D., M.D.

Plastic and Reconstructive Surgery: March 2018 - Volume 141 - Issue 3 - p 646–650
doi: 10.1097/PRS.0000000000004110
Cosmetic: Ideas and Innovations
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Background: Early intervention might improve the quality of surgical scars. Botulinum toxin type A has been shown to improve surgical scars in the past decade. The purpose of this study was to evaluate the effect of botulinum toxin type A on surgical facial scars.

Methods: In this prospective, split-scar, double-blind, randomized controlled trial, 16 consecutive patients who underwent facial surgery between June and October of 2015 were enrolled. Botulinum toxin type A was injected randomly into half of each surgical wound closure immediately after surgery. The scars were assessed independently by two plastic surgeons at a 6-month follow-up visit using the Vancouver Scar Scale and the visual analogue scale. The scar width was also measured.

Results: Fourteen patients completed the study. The visual analogue scale score and scar width measurements revealed a significant improvement in appearance and narrower scars for the botulinum toxin type A–treated halves of the scars (p = 0.046 and p = 0.001, respectively). The mean Vancouver Scar Scale score was 4.68 for the botulinum toxin type A–injected group and 5.24 for the control group (p = 0.15). In addition, the Vancouver Scar Scale height score was significantly different between the two groups (p = 0.008).

Conclusion: This study demonstrates that early postsurgical botulinum toxin injections can produce better, narrower, and flatter facial surgical scars.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Shanghai, People’s Republic of China

From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine.

Received for publication December 1, 2016; accepted September 6, 2017.

This trial is registered under the name “Effect of Botulinum Toxin Type A on Facial Surgical Scars: A Prospective, Self-Controlled Clinical Study,” Chinese Clinical Trials Registry number ChiCTR-OIB-15007448 (http://www.medresman.org/pub/cn/proj/projectshow.aspx?proj=1419).

The first two authors contributed to the work equally and should be regarded as a co–first authors.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (www.PRSJournal.com).

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

Yunbo Jin, Ph.D., M.D., Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, People’s Republic of China, docjinyunbo@163.com, Xiaoxi Lin, Ph.D., M.D., Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai 200011, People’s Republic of China, linxiaoxi@126.com

©2018American Society of Plastic Surgeons