Botulinum toxin A adjunctive use in manual chemabrasion: controlled long-term study for treatment of upper perioral vertical wrinkles.
BACKGROUND
The treatment of perioral vertical wrinkles is a very common request from female patients as of their 40th decade of life. Actinic damage, cigarette smoking, loss of deep structures volume, sleep positions, orthodontic deformities, and dynamic components have been thought to cause this aesthetic problem.


OBJECTIVE
The objective was to investigate the combination of botulinum toxin type A (BoNTA) pretreatment of the orbicularis oris muscle with manual chemabrasion to increase its clinical efficacy in the therapy of upper perioral vertical rhytides.


METHODS
Twelve women presenting moderate to severe upper lip vertical rhytides were randomized to receive two unilateral BoNTA injections at the vermilion border, 1 week before chemabrasion (35% trichloroacetic acid followed by dermasanding) of the upper perioral cosmetic unit. Wrinkle severity was assessed by two blinded observers at baseline, 30 days, 90 days, 180 days, and 3 years by using a four-point Facial Wrinkle Severity Scale (FWSS).


RESULTS
From Day 90 to Year 3, the BoNTA-injected sides showed smaller grades in the FWSS than control sides (p<.05).


CONCLUSIONS
Previous injections of BoNTA improve short- and long-term results of chemabrasion in the upper lip region.
Kadunc
Bogdana Victoria
BV
Dermatologic Clinic, Hospital do Servidor Publico Municipal, São Paulo, Brazil. bog@uol.com.br
Trindade DE Almeida
Ada Regina
AR
Vanti
Adriana Amorin
AA
DI Chiacchio
Nilton
N
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002615:Chemexfoliation; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008046:Lip / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A