Botulinum toxin type A treatment to the upper face: retrospective analysis of daily practice

Figures & data

Figure 1 Diagram showing treatment flow.

Note: The three possible treatments and treatment intervals are shown, along with the nine possible treatment combinations.

Table 1 Components of questionnaire completed by physicians

Variables

Demographics and baseline characteristics

The following variables were considered as demographics and baseline characteristics: Gender (male/female) Age (years) Used botulinum toxin (Bocouture^®/Xeomin^®; Vistabel^®/Botox^®; Azzalure^®/Dysport^®) Treated indication (glabellar frown lines, horizontal forehead lines, crow’s feet)

Side effects

Investigators were asked if any side effects occurred during the treatment period. If so, the nature of the side effects could be specified by choosing one or more of the following possible answers: Local pain Local hematoma Headache Ptosis of the upper eyelid Ptosis of the eyebrows Other In addition, the severity of the most relevant side effect could be assessed (mild, moderate, severe)

Satisfaction with product

The investigator was asked to assess his/her satisfaction with the product (physician’s satisfaction) as well as to transcribe the subject’s satisfaction from subject documentation. The following answers were possible: Satisfied Not satisfied Unknown

Change of product

Participants were asked if the neurotoxin product was changed during the treatment period. If so, the following reasons could be assigned: Dissatisfaction with cosmetic result Dissatisfaction due to side effects Other

Treatment details

The treatment details were recorded for at least two but not more than three injections. The following data were collected: Treatment date Time interval until the next treatment in the same indication Overall dose for the treatment in this indication Individual doses for each injection point, where it was possible to choose between 24 different injection points

Table 2 Demographic and baseline characteristics

	n (%)
Total number of subjects	1256 (100)
Gender
Male	105 (8.4)
Female	1151 (91.6)
Indication
Glabellar frown lines	1096 (48.3)
Horizontal forehead lines	621 (27.4)
Crow’s feet	553 (24.4)
Product
IncobotulinumtoxinA	1998 (88.0)
OnabotulinumtoxinA	236 (10.4)
AbobotulinumtoxinA	36 (1.6)
Product change
Missing	3 (0.1)
No	2018 (88.9)
Yes	249 (11.0)
Age, years
Mean	47.4
STD	10.91
Maximum	94.0
Median	46.0
Minimum	20.0

Abbreviation: STD, standard deviation.

Table 3 Average interval between treatments in the upper face for subjects without product change

	Interval 1		Interval 2
	IncobotulinumtoxinA	OnabotulinumtoxinA	IncobotulinumtoxinA	OnabotulinumtoxinA
Mean, weeks	25.25	24.90	22.43	21.95
STD	15.21	12.65	10.55	7.87
Median	22.43	23.29	20.57	20.86
	P = 0.9646		P = 0.8696

Note: P value calculated using the Wilcoxon–Mann–Whitney test.

Abbreviation: STD, standard deviation.

Table 4 Mean total treatment doses in the upper face at each treatment visit for subjects with and without product change

Treatment visit	Subjects without product change		Subjects with product change
	IncobotulinumtoxinA Dose (U)	OnabotulinumtoxinA Dose (U)	IncobotulinumtoxinA Dose (U)	OnabotulinumtoxinA Dose (U)
1
Mean	18.92	18.79	17.48	16.99
STD	9.2	8.77	9.62	6.38
	P = 0.4335		P = 0.9138
2
Mean	18.12	18.44	17.13	18.63
STD	8.85	6.80	6.62	9.34
	P = 0.4262		P = 0.3168
3
Mean	18.20	18.94	17.97	18.11
STD	9.39	4.68	5.8	8.01
	P = 0.6900		P = 0.7007

Note: P value calculated using the Wilcoxon–Mann–Whitney test.

Abbreviation: STD, standard deviation.