Quantitative Analysis

With over 6.1 million procedures conducted in 2012 and an annual growth rate of 8 percent, neuromodulation with botulinum toxin type A stands out as the most commonly performed aesthetic intervention, encompassing both nonsurgical and surgical procedures in the United States.1 Although the U.S. Food and Drug Administration–approved botulinum toxin type A injection sites are limited to the glabella and lateral canthal rhytides, aesthetic neuromodulation applications have significantly expanded. These now commonly include the treatment of forehead rhytides, perioral rhytides, masseter hypertrophy, platysmal banding, and more.

Despite the widespread use of botulinum toxin type A, there is a notable lack of objective, reproducible, and quantifiable data for comparative toxin analysis. Previous clinical evaluations of toxins, both individually and comparatively, have relied on static photography along with potentially subjective, albeit validated scores (e.g., Facial Wrinkle Scale, Modified Fitzpatrick Wrinkle Scale, Glabellar Line Severity Score), field of anhidrosis analyses, or even electromyography.2–7 While these various methodologies have provided crucial data on the efficacy and safety of toxins for static rhytide improvement, they fall short in accurately capturing and evaluating the true dynamic rhytide alteration following a given dose of toxin.