Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2025
Efficacy and safety of onabotulinumtoxin A in the treatment of platysma prominence: A systematic review and meta-analysis of randomized clinical trials.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Udoma-Udofa Ofonime Chantal, Ribeiro Luiz Fábio Silva, de Freitas Lucas Rezende, de Sousa Rodrigo Alves, Borges Maísa de Souza, de Oliveira Tauãna Terra Cordeiro, Rajan Divya, Kreutz-Rodrigues Lucas
Аннотация
INTRODUCTION: The platysma muscle influences lower face and neck aesthetics and expression. Aging can lead to platysma prominence (PP), manifesting as visible neck bands that affect appearance and well-being. Although surgical treatments exist, they are invasive and carry notable risks. This systematic review and meta-analysis evaluated the efficacy and safety of onabotulinumtoxinA for treating PP.
METHODS: We systematically searched the PubMed, Cochrane Library, and Embase databases through May 2025 for studies comparing onabotulinumtoxinA with placebo. Primary outcomes were ≥1-grade bilateral neck improvement on Participant Allergan Platysma Prominence Scale (P-APPS) and Clinician Allergan Platysma Prominence Scale (C-APPS) at days 14, 60, and 120. Secondary outcomes included patient satisfaction evaluated using the Appearance of Neck and Lower Face Questionnaire and safety indicators such as bruising, hemorrhage, post-dose swallowing or talking difficulties, and other adverse events.
RESULTS: Three randomized controlled trials with 1003 intention-to-treat and 912 modified intention-to-treat patients were included. OnabotulinumtoxinA significantly improved P-APPS on days 14 (RR 3.64), 60 (RR 3.46), and 120 (RR 2.57), and C-APPS on days 14 (RR 4.03), 60 (RR 3.73), and 120 (RR 2.21), all p < 0.01. Patient satisfaction was also higher on days 14 (RR 5.71), 60 (RR 5.56), and 120 (RR 5.29), all p < 0.01. No significant differences were found in the safety outcomes between the onabotulinumtoxinA and placebo groups.
CONCLUSION: OnabotulinumtoxinA provides significant and sustained improvements in aesthetic and psychosocial outcomes in patients with PP, without increased risk of adverse events. These findings support its role as a less invasive and effective alternative to surgery.
METHODS: We systematically searched the PubMed, Cochrane Library, and Embase databases through May 2025 for studies comparing onabotulinumtoxinA with placebo. Primary outcomes were ≥1-grade bilateral neck improvement on Participant Allergan Platysma Prominence Scale (P-APPS) and Clinician Allergan Platysma Prominence Scale (C-APPS) at days 14, 60, and 120. Secondary outcomes included patient satisfaction evaluated using the Appearance of Neck and Lower Face Questionnaire and safety indicators such as bruising, hemorrhage, post-dose swallowing or talking difficulties, and other adverse events.
RESULTS: Three randomized controlled trials with 1003 intention-to-treat and 912 modified intention-to-treat patients were included. OnabotulinumtoxinA significantly improved P-APPS on days 14 (RR 3.64), 60 (RR 3.46), and 120 (RR 2.57), and C-APPS on days 14 (RR 4.03), 60 (RR 3.73), and 120 (RR 2.21), all p < 0.01. Patient satisfaction was also higher on days 14 (RR 5.71), 60 (RR 5.56), and 120 (RR 5.29), all p < 0.01. No significant differences were found in the safety outcomes between the onabotulinumtoxinA and placebo groups.
CONCLUSION: OnabotulinumtoxinA provides significant and sustained improvements in aesthetic and psychosocial outcomes in patients with PP, without increased risk of adverse events. These findings support its role as a less invasive and effective alternative to surgery.