From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Mount Sinai Hospital.
Plast Reconstr Surg. 2020 Jul;146(1):157-170. doi: 10.1097/PRS.0000000000006908.
Since their introduction to clinical medicine in 1989, botulinum toxin injections have been used for many indications. First used for nonsurgical management of strabismus, botulinum toxin injections are now widely used in plastic and reconstructive surgery for aesthetic indications; however, nonaesthetic indications of botulinum toxin have grown tremendously over the past two decades and span numerous specialties, including urology, dermatology, ophthalmology, otolaryngology, gynecology, plastic surgery, general surgery, and neurology. The present review aims to highlight nonaesthetic indications of botulinum toxin that are most relevant to the plastic surgeon with an emphasis on evidence-based practice.
A PubMed search with manual reference checking was conducted to find the most relevant and influential articles on the nonaesthetic uses of botulinum toxin within the realm of adult plastic surgery. Studies were then categorized into areas of use, and quality of evidence for each category was highlighted.
Botulinum toxin has numerous nonaesthetic indications in plastic surgery, including for select pain-related disorders, skeletal muscle activity disorders, exocrine gland hyperfunction, wound healing, Raynaud phenomenon, abdominal wall reconstruction, and prosthetic breast reconstruction and augmentation. Although these indications have been widely reported, high-quality evidence supporting efficacy, optimal dose, and injection protocol with randomized controlled trials is lacking in many areas.
Botulinum toxin is widely used in plastic surgery for a variety of nonaesthetic indications. Future studies should focus on investigating efficacy and best practice with high level of evidence research.
自 1989 年引入临床医学以来，肉毒毒素注射已被用于多种适应证。肉毒毒素最初用于斜视的非手术治疗，现已广泛用于整形和重建外科的美容适应证；然而，在过去的二十年中，肉毒毒素的非美容适应证已大大增加，涵盖了许多专业领域，包括泌尿科、皮肤科、眼科、耳鼻喉科、妇科、整形外科学、普通外科学和神经科。本综述旨在强调与整形外科医生最相关的肉毒毒素的非美容适应证，并重点介绍基于循证实践的内容。
通过 PubMed 搜索并手动参考检查，寻找与成人整形外科学中肉毒毒素非美容用途最相关和最有影响力的文章。然后将研究分为使用领域，并突出每个类别的证据质量。
肉毒毒素在整形手术中有许多非美容适应证，包括用于选择与疼痛相关的疾病、骨骼肌活动障碍、外分泌腺功能亢进、伤口愈合、雷诺现象、腹壁重建以及假体乳房重建和隆胸。尽管这些适应证已广泛报道，但在许多领域缺乏支持疗效、最佳剂量和随机对照试验注射方案的高质量证据。
肉毒毒素在整形手术中广泛用于多种非美容适应证。未来的研究应重点调查具有高证据水平的疗效和最佳实践。
