Impact of botulinum toxin for facial aesthetics on psychological well-being and quality of life: Evidence-based review. Issue 12 (December 2022)

• Record Type: Journal Article
• Authors: Pereira, Ines Novo; Hassan, Haidar
• Is Part Of: Journal of plastic, reconstructive & aesthetic surgery. Volume 75:Issue 12(2022)
• Page Start: 4450
• Page End: 4463
• Publication Date: 2022-12
• Subjects: Aesthetic -- Botulinum toxin -- Psychological well-being -- Quality-of-life; Surgery, Plastic -- Great Britain -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.bjps.2022.08.063
• Languages: English
• ISSNs: 1748-6815

Abstract

Summary: Background: There has been a steady growth of non-surgical minimally invasive procedures. In parallel, an ever-broadening range of clinicians has been engaging with botulinum toxin (BoNT) for aesthetic procedures, with reportedly compound positive impact on social health and psychological well-being. Objective: To identify and critically appraise current literature on the impact of BoNT injections into the upper face, as a sole treatment/combination with other modalities on facial aesthetics, psychological well-being, and quality-of-life. Methods: An evidence-based review was performed using advanced search from PubMed, Cochrane Library of Systematic Reviews, and Central Register of Controlled Trials databases . Only literature from inception to August, 2021 were considered. Eligibility criteria included human studies, FDA-approved BoNT applications, formulations, and dosages as a sole/multimodal approach; studies including patient-reported outcome tools psychometrically validated and facial lines-specific. Observer-reported outcome instruments were also considered for a thorough evaluation of outcomes. Results: Based on data investigations and participant assessments, all studies showed statistically significant improvement in psychosocial well-being and quality-of-life domains with a trend for highest impact when multiple upper facial areas are treated in a multimodal approach. Conclusion: Aesthetic BoNT showed links to true health benefits for well-selected patients in addition to physical amelioration. However, the biological rational remains ambiguous. Well-designed controlled trials are needed, without pharmaceutical laboratories bias, in real clinical scenarios of patients paying for the interventions, often involving multiple areas with/without combined treatments. The persistence of positive outcomes following repetitive treatments provided by less experienced practitioners, potentially involving suboptimal patient selection and/or aesthetic results, warrants further investigation.