Full-face aesthetic treatment with onabotulinumtoxin A: Results from a retrospective real world analysis

Abstract

Background: Full-face aesthetic treatment with neuromodulators is common in routine practice but not widely analyzed in clinical studies. Methods: This was a retrospective, two-center chart review evaluating the effectiveness and safety of full-face onabotulinumtoxinA injections for the aesthetic treatment of adult females, all of whom had severe forehead lines at baseline. Patients received a total dose of 114 U: 64 U in the upper face using the on-label treatment pattern for glabellar, crow's feet, and forehead lines; 20 U per side in the jawline based on the recently proposed "toxin lift" method; and 10 U in the chin. Results: Thirty-three females were included (mean age: 42.5 +/- 7.6 years). Physician-rated forehead line severity improved from "severe" to "mild" or "none" in all patients at 4 weeks, as assessed using the Facial Wrinkle Scale and Forehead Lines Grading Scale. All study participants showed greater facial symmetry, enhanced jawline contour, and high patient satisfaction (FACE-Q Satisfaction with Outcome, 83.9 +/- 9.0; Satisfaction with Forehead and Eyebrows, 95.4 +/- 5.7). Adverse events were minor and transient. Conclusions: Full-face onabotulinumtoxinA was effective in reducing facial lines and improving overall symmetry and jawline contour, with high levels of patient satisfaction, and a favorable safety profile. Level of Evidence: Level III. (c) 2025 The Authors. Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)