SynthesisAesthetic surgery journal2022
Complications of Cosmetic Botulinum Toxin A Injections to the Upper Face: A Systematic Review and Meta-Analysis.
Synthesis in Aesthetic surgery journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06448676 (Head-to-Head Comparison of the Efficacy and Safety of All Five Commercially Available Botulinum Neurotoxin Type A Products for the Treatment of Glabellar Rhytides), which is not on this map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Head-to-Head Comparison of the Efficacy and Safety of All Five Commercially Available Botulinum Neurotoxin Type A Products for the Treatment of Glabellar Rhytides: A Multicenter, Double-Blind, Randomized Controlled Trial
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Cosmetic Botulinum Toxin A Injections to the Upper Face: A Systematic Review and Meta-Analysis of Clinical Studies.Journal of cosmetic dermatology · 2026Pooled it
- Non-Surgical Ear Rejuvenation Through Selective Neuromodulation with Onabotulinum and Abobotulinum Toxin-A.Toxins · 2026Article
- Global Research Trends and Thematic Evolution in Injectable Aesthetic Medicine: A 25-year Bibliometric Analysis (2000-2025).Plastic and reconstructive surgery. Global open · 2026Article
- Global Pharmacovigilance of Aesthetic Botulinum Toxin Type A: Analysis of Adverse Event Reports From the USA, Europe, Canada, and Australia.Journal of cosmetic dermatology · 2026Article
- Experience with injectables performed at a resident department Aesthetic Surgery Clinic.JPRAS open · 2026Article
- Management of Complications Following Botulinum Toxin Facial Injections: A Narrative Review.Cureus · 2026Review
- Monitoring complications of botulinum toxin in community practice: A pharmacological study.Bioinformation · 2026Article
- An Unusual Iatrogenic Complication of Botulinum Toxin: Forearm Flexor Weakness Following a Nonstandard Intradermal Sensitivity Test.Aesthetic surgery journal. Open forum · 2026Article
- Mapping the UK Aesthetic Medicine Industry: Practitioner Profiles, Pricing, and Socioeconomic Gradients in Botulinum Toxin Practice.Aesthetic surgery journal. Open forum · 2026Article
- Botulinum Toxin and Redress in the United Kingdom, Findings From a Cross-Sectional Survey.Journal of cosmetic dermatology · 2026Article
- Article
- Upper Extremity Muscle Weakness Following Axillary Botox Injection With Sterile Water Reconstitution: A Case Report.Clinical case reports · 2025Article
- Notes From the Field: Severe Illnesses After Self-Injection of Botulinum Toxin Purchased Online - New York, Texas, and Wisconsin, 2025.MMWR. Morbidity and mortality weekly report · 2025Article
- Main facial anatomical concerns of dentists to perform botox injections.Journal of clinical and experimental dentistry · 2025Article
- Article
- Observation of Safety and Efficacy of Botulinum Toxin Type A in the Treatment of Tear Troughs and Mild Yelid Bags.Journal of cosmetic dermatology · 2025Article
- Effect of Synchronized Radiofrequency and High-Intensity Facial Electrical Stimulation (HIFES) of the Upper Face.Aesthetic surgery journal · 2025Article
- Unilateral Blepharoptosis Combined With Malignant Exophthalmos After Botulinum Toxin Injection to Glabellar Lines: A Case Report.Journal of cosmetic dermatology · 2025Article
- Findings From the Great British and Northern Ireland Botulinum Toxin Survey: Treatment Outcomes, Patient Experience, and Regulations From a Cross-Sectional Survey.Aesthetic surgery journal. Open forum · 2025Article
- Iatrogenic Botulism After Cosmetic Use of Botulinum Toxin-A: A Case Series.Clinical case reports · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBotulinum toxin A (BoNT-A) injections are a popular non-surgical procedure for facial rejuvenation. Its increase in popularity and utilization is met with limited regulations, potentially posing a significant risk to patient safety and public health.
objectivesThe authors sought to assess the safety profile of cosmetic glabellar and forehead BoNT-A injections and evaluate BoNT-A type on complication rate.
methodsA systematic search of MEDLINE and EMBASE was performed for studies reporting complications after cosmetic BoNT-A in the glabellar or in the forehead region in the glabellar or in the forehead region. A random effects meta-analysis was carried out to assess complication rate. Where there were sufficient randomized-controlled trials, a network meta-analysis was performed.
resultsOf 556 identified articles, 24 were included in the final quantitative analysis, with 4268 BoNT-A injection sessions and 1234 placebos. Frequently observed treatment-related complications in the BoNT-A intervention group included headache, local skin reactions, and facial neuromuscular symptoms. The overall BoNT-A complication rate was 16%. The odds ratio of developing complications from abobotulinum toxin injections compared with placebo was 1.62 (1.15, 2.27; P > 0.05) and that from onabotulinum toxin injections compared with placebo was 1.34 (0.52, 3.48; P > 0.05). In 30% of the studies, the injectors were doctors, whereas the training status of the practitioner was not reported in the remaining 70%.
conclusionsCosmetic BoNT-A injections in the glabellar and forehead region appear to be safe, and most complications are mild and transient. Nevertheless, the literature demonstrates heterogeneous reporting of complications and a lack of consistency of the definition of treatment-related complications. LEVEL OF EVIDENCE: 2:
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.