ArticlePlastic and reconstructive surgery. Global open2022
Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus.
Article in Plastic and reconstructive surgery. Global open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 33 citations in OpenAlex.
- Italian Expert Consensus on the Efficacy and Safety of High Doses of Incobotulinum Toxin A (BocoutureDermatology and therapy · 2026Review
- Review
- A Phase 2, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of OBI-858 for the Treatment of Moderate-to-Severe Glabellar Lines.Dermatology and therapy · 2025Article
- Reversal of partial botulinum toxin A resistance following Janus kinase inhibition with tofacitinib: A case series.JAAD case reports · 2025Article
- Customizing Microfocused Ultrasound With Visualization Treatment for Facial Lifting in Asian Men: Experience and Practical Insights From Korea.Journal of cosmetic dermatology · 2025Article
- Multimodal Treatment Combinations and Layering to Restructure the Aging Face: Recommendations From an Expert Panel.Plastic and reconstructive surgery. Global open · 2025Article
- Efficacy and Safety of Incobotulinumtoxin-A for Trapezius Muscle Reduction: Quantitative Evaluation With Imaging Studies.Plastic and reconstructive surgery. Global open · 2025Article
- Exploring Nonresponse to Botulinum Toxin in Aesthetics: Narrative Review of Key Trigger Factors and Effective Management Strategies.JMIR dermatology · 2025Review
- A Rare Case of Delayed-Onset Hypersensitivity Reaction and Complete Secondary Treatment Failure Following Repeated Cosmetic Botulinum Toxin Type A Injections.Journal of cosmetic dermatology · 2025Article
- Botulinum Toxin Therapy: A Comprehensive Review on Clinical and Pharmacological Insights.Journal of clinical medicine · 2025Review
- Identifying Different Immunoresistance Risk Profiles Among Experienced Aesthetic Botulinum Neurotoxin A Recipients: A Latent Class Analysis.Journal of cosmetic dermatology · 2025Article
- Resistance to cosmetic botulinum toxin A: A 15-patient case series across 12 sites.JAAD international · 2025Article
- Immunogenicity of Botulinum Toxin Type A in Different Clinical and Cosmetic Treatment, a Literature Review.Life (Basel, Switzerland) · 2024Review
- Real-world Implications of Botulinum Neurotoxin A Immunoresistance for Consumers and Aesthetic Practitioners: Insights from ASCEND Multidisciplinary Panel.Plastic and reconstructive surgery. Global open · 2024Article
- Aesthetic doctors' perception and attitudes toward tolerance in botulinum toxin.Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) · 2024Article
- Complexing Protein-Free Botulinum Neurotoxin A Formulations: Implications of Excipients for Immunogenicity.Toxins · 2024Review
- Efficacy and Safety Analysis of Botox Application and Iatrogenic Botulism: Panacea or Peril?Current pharmaceutical design · 2024Review
- Microtoxin for Improving Pore Size, Skin Laxity, Sebum Control, and Scars: A Roundtable on Integrating Intradermal Botulinum Toxin Type A Microdoses Into Clinical Practice.Aesthetic surgery journal · 2023Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Botulinum neurotoxin A (BoNT-A) injection is the most widely performed aesthetic procedure and a first-line therapeutic option for various medical conditions. The potential for BoNT-A immunoresistance and secondary nonresponse related to neutralizing antibody (NAb) formation warrants attention as the range of BoNT-A aesthetic applications continues to expand. Methods: An international multidisciplinary panel reviewed published evidence on BoNT-A immunoresistance in aesthetic and therapeutic applications and discussed best practices integrating clinical, ethical, and aesthetic considerations. Consensus statements relating to awareness, assessment, and management of the risk of NAb-related secondary nonresponse in aesthetic practice were developed. Results: There was a consensus that, as doses used in aesthetic practice become like those in therapeutics, rates of NAb formation may be expected to increase. However, the true extent of NAb formation in aesthetics is likely underestimated due to limitations of published evidence and variability in treatment patterns of aesthetic patients. Since BoNT-A therapy is often lifelong, practitioners need to recognize immunogenicity as a potential complication that might affect future therapeutic use and strive to minimize modifiable risk factors. The selection and use of a BoNT-A product with the least immunogenic potential from the beginning may thus be advantageous, especially when treatment with high doses is planned. Conclusions: In view of current trends in BoNT-A aesthetic use, it is essential for practitioners to conduct thorough clinical assessments, inform patients of treatment risks, and develop BoNT-A treatment plans to minimize immunogenicity. This can help preserve the option of continued or future BoNT-A treatment with satisfactory outcomes.
Identifiers
What OpenQuestion holds
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.