Foissac Rémi, Benatar Marc J
Plastic and reconstructive Surgery, Clinique Saint George, Nice, France.
Plastic and reconstructive Surgery, Clinique Santa Maria, Nice, France.
J Cosmet Dermatol. 2021 May;20(5):1405-1410. doi: 10.1111/jocd.13980. Epub 2021 Feb 12.
Botulinum toxin type A (BoNT-A) injection remains the leading medical cosmetic procedure worldwide, with a high rate of patient satisfaction. However, it still suffers from patients' fear of being unable to transmit their emotions and of looking frozen from unnatural results.
This study aimed to determine whether BoNT-A can decrease the intensity of emotions in facial expressions.
PATIENTS/METHODS: In this single-center prospective study, 42 patient investigators assessed four patients' facial expressions for six emotions and neutral faces, before and after injection of 36 IU or 48 IU of onabotulinumtoxinA, using photographs. Photographs were presented on a tablet to the investigators.
There were no statistical differences between the before and after photographs for the intensity of emotions for all expressions (P > .05) except for the expression of surprise in the group of patients that received 48 IU of the injection (protocol with injection of the frontalis muscle). All patient investigators answered negatively to the question "Do you think that this patient has a 'frozen face'?".
This study shows that esthetic injection of BoNT-A in the upper face has no negative effects on facial expressions and does not lead to the feared "frozen face" when it is injected with respect for best practice guidelines. This study can be used as an example for patients who have some reticences against BoNT-A injection.
A型肉毒毒素（BoNT-A）注射仍是全球领先的医学美容手术，患者满意度很高。然而，它仍然存在患者担心无法传达自己的情感以及因不自然的效果而显得面部僵硬的问题。
本研究旨在确定BoNT-A是否能降低面部表情中情绪的强度。
患者/方法：在这项单中心前瞻性研究中，42名患者研究者在注射36 IU或48 IU的A型肉毒毒素前和后，使用照片评估4名患者六种情绪和中性表情的面部表情。照片在平板电脑上呈现给研究者。
除了接受48 IU注射（额肌注射方案）的患者组中惊讶表情外，所有表情的情绪强度在注射前后的照片之间没有统计学差异（P > 0.05）。所有患者研究者对“你认为这名患者有‘面部僵硬’吗？”这个问题的回答均为否定。
本研究表明，在上面部进行BoNT-A美容注射对面部表情没有负面影响，并且在按照最佳实践指南进行注射时不会导致令人担忧的“面部僵硬”。本研究可为对BoNT-A注射有所顾虑的患者提供范例。
