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J Clin Aesthet Dermatol. 2013 Sep;6(9):41-5.

Impact of botulinum toxin a on the quality of life of subjects following treatment of facial lines.

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The Jandhyala Institute, Banbury, United Kingdom.



To investigate quality of life and its correlation to patient satisfaction before and after treatment with botulinum toxin A.


Quality of life was assessed using the Schedule for the Evaluation of Individual Quality of Life Direct-Weighting tool. Patients identified the five areas of their life of the greatest importance to them, weighted the areas as to their relative importance, and rated their status in each area on a visual scale before treatment (old cues) and 28 days later (using both old cues and newly defined and weighted cues). At both visits, patients also rated their overall quality of life using a visual analogue scale. Patient satisfaction with their appearance was measured using a 10-point scale in conjunction with standardized photographs taken at each visit.


Fifty-three patients (median age 39.5 years; 87% women) with moderate-to-severe wrinkles of the glabella, forehead, or crow's feet were enrolled. Treatment with incobotulinumtoxinA consistently resulted in a significant improvement in quality of life according to Schedule for the Evaluation of Individual Quality of Life Direct-Weighting tool index scores (old cues, P=0.0006; new cues P=0.0235) and patient assessment of their overall quality of life (P<0.0001 for both old and new cues). Family, work, finance, relationships, and health were the five most frequently identified cues at each assessment. No correlation between quality of life and satisfaction scores was found, although both were significantly increased after treatment.


These results support the contention that quality of life is significantly improved following botulinum toxin A treatment and that consideration should be given to incorporating the measurement of quality of life as an outcome measure following botulinum toxin A treatment, especially as satisfaction does not correlate to quality of life.


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