Full-face aesthetic treatment with onabotulinumtoxin A: Results from a retrospective real world analysis.

Background: Full-face aesthetic treatment with neuromodulators is common in routine practice but not widely analyzed in clinical studies. Methods: This was a retrospective, two-center chart review evaluating the effectiveness and safety of full-face onabotulinumtoxinA injections for the aesthetic treatment of adult females, all of whom had severe forehead lines at baseline. Patients received a total dose of 114 U: 64 U in the upper face using the on-label treatment pattern for glabellar, crow's feet, and forehead lines; 20 U per side in the jawline based on the recently proposed "toxin lift" method; and 10 U in the chin. Results: Thirty-three females were included (mean age: 42.5 ± 7.6 years). Physician-rated forehead line severity improved from "severe" to "mild" or "none" in all patients at 4 weeks, as assessed using the Facial Wrinkle Scale and Forehead Lines Grading Scale. All study participants showed greater facial symmetry, enhanced jawline contour, and high patient satisfaction (FACE-Q Satisfaction with Outcome, 83.9 ± 9.0; Satisfaction with Forehead and Eyebrows, 95.4 ± 5.7). Adverse events were minor and transient. Conclusions: Full-face onabotulinumtoxinA was effective in reducing facial lines and improving overall symmetry and jawline contour, with high levels of patient satisfaction, and a favorable safety profile. Level of Evidence: Level III.