A Prospective Observational Study of the Effectiveness and Safety of Botulinum Toxin in the Horizontal Neck Lines

Botulinum toxin is used extensively, and its use for aesthetic indications in the lower face and neck is now becoming increasingly popular. It is the ideal alternative to surgical procedures for patients who are too young for facelift surgery or who are unwilling to take recuperation time. We review current approaches to BTX A treatment for horizontal neck lines. Subjects were 20 women with an average age of 43 with mild to moderate horizontal neck lines but have had no treatment by BTX A for the past 3 months. Injections are performed at points 1-1.5 cm apart along the horizontal lines with 1-2 U in each injection site, for a total of 15-30 U. Patients were followed up 3 and 8 days after treatment and then every 4 weeks after initial treatment for 16 weeks. Except day 3 in the first neck line, the mean resulting from evaluation by the actual physician who performed the injection and two blinded physicians has statistical significance as shown by the maximum results at 8 weeks after injection. However, the patient improvement rate and satisfaction level did not exceed 50%. Adverse reactions were mild and transitory. The overall results of applying BTX A are excellent, and the satisfaction level of treated patients is high to a certain extent. Moreover, smoothening of the neck skin was observed due to the intradermal effect. It is also a safe and effective therapeutic modality for any patient desiring rejuvenation of his or her neck, but who at the same time does not desire any recuperation time or is unwilling to undertake the potential risks associated with surgical procedures. 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.