Meta-Analysis of Adverse Reactions of Botulinum Toxin A in Facial Rejuvenation Treatment.

Weiqiang Zhang, Yuqing Wen, Yi Zhong, Qingxia Chen

Abstract readMeta-Analysis

In one paragraph

Synthesis in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it

0cells of the map it votes in

1citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Complications of Botulinum Toxin, Fillers, and Threads: A Narrative Review by the Special Interest Group (SIG) Aesthetics, Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) Academy.Cureus · 2026
Review

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Weiqiang ZhangBurn, Plastic and Wound Repair Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Zhongcheng Street, Xinluo District, Longyan, 364000, Fujian Province, China.

Yuqing WenBurn, Plastic and Wound Repair Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Zhongcheng Street, Xinluo District, Longyan, 364000, Fujian Province, China.

Yi ZhongBurn, Plastic and Wound Repair Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Zhongcheng Street, Xinluo District, Longyan, 364000, Fujian Province, China. fjyxdz82@163.com.

Qingxia ChenBurn, Plastic and Wound Repair Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No.105, Jiuyi North Road, Zhongcheng Street, Xinluo District, Longyan, 364000, Fujian Province, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFacial rejuvenation is a popular non-surgical treatment, and its treatment safety is of key significance to patients. The purpose of this meta-analysis is to compare the effects of botulinum toxin A and placebo on the occurrence of adverse reactions in facial rejuvenation treatment.

objectiveAccording to PRISMA guidelines, a comprehensive search was conducted in Chinese and English databases, and 20 randomized controlled trials (RCTs) were included. The main result is to evaluate the level of adverse events (AEs), and the secondary result is to evaluate the level of AEs in crow's feet (CFL), glabellar lines (GL), and forehead lines (FHL).

methodsThe randomized, double-blind, placebo-controlled clinical trial of botulinum toxin A for facial rejuvenation published up to August 2023 was searched by computer, and the completed data were retrieved manually. Two researchers screened out the included studies and evaluated the quality of the literature, and analyzed the included studies with Revman 5.3 software.

resultsThe 20 RCTs literatures included 7275 cases in the experimental group and 2552 cases in the control group. The AEs level in the experimental group was significantly higher than that in the placebo group (RR=1.22; 95%CI 1.13-1.32; p < 0.00001), and the level of heterogeneity is low (P = 0.11, I2 = 29%). The AE level of patients in CFL test group was significantly higher than that in control group (RR = 1.13; 95%CI 1.02-1.04; P = 0.01), and the level of heterogeneity is low (P = 0.14, I2 = 38%). The level of AE in GL experimental group was significantly higher than that in control group (RR = 1.42; 95%CI 1.21-1.67; p < 0.0001), and the level of heterogeneity is low (P = 0.60, I2 = 0%). The AE level of patients in FHL experimental group was significantly higher than that in control group (RR = 1.53; 95%CI 1.12-2.10; p < 0.008), and the level of heterogeneity is low (P = 0.99, I2 = 0%).

conclusionThis meta-analysis confirmed the safety of BTX-A in the treatment of facial rejuvenation (CFL, GL, FHL). Although the incidence of adverse reactions was low, there was still a significant difference compared with the placebo control group. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Indexed as

Botulinum Toxins, Type ACosmetic TechniquesNeuromuscular AgentsRejuvenationSkin AgingFaceHumansRandomized Controlled Trials as TopicTreatment OutcomeBotulinum Toxins, Type ANeuromuscular AgentsAdverse reactionsBotulinum toxin AFacial rejuvenationNon-surgical cosmetic treatmentsSafety profile

Identifiers

PMID39623228

DOI10.3390/toxins14040268

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

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.