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Prospective evaluation of incobotulinumtoxinA in the management of the masseter using two different injection techniques

Authors Nikolis A, Enright KM, Masouri S, Bernstein S, Antoniou C

Received 7 February 2018

Accepted for publication 8 May 2018

Published 12 July 2018 Volume 2018:11 Pages 347—356

DOI https://doi.org/10.2147/CCID.S164848

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Jeffrey Weinberg


Video abstract presented by Andreas Nikolis.

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Andreas Nikolis,1–4 Kaitlyn M Enright,1,3–5 Sofia Masouri,5 Steven Bernstein,6 Christina Antoniou7

1Victoria Park Medispa, Westmount, 2Department of Plastic Surgery, University of Montreal, 3VP Research Unit, 4Erevna Innovations Inc., 5Department of Experimental Surgery, McGill University, Montreal, QC, Canada; 6Department of Dermatology, University of Montreal, Montreal, QC, Canada; 7Department of Dermatology, National and Kapodistrian University of Athens, Athens, Greece

Background: IncobotulinumtoxinA (Xeomin Cosmetic®) has been used previously in the management of masseteric hypertrophy. However, a standardized injection technique has not been established. The goal of the present study was to evaluate the efficacy and safety of two injection techniques in the management of masseteric hypertrophy using incobotulinumtoxinA.
Methods: Thirty female patients with masseteric hypertrophy were recruited and evenly randomized to receive bilateral treatments of either a single-injection technique (SIT) or a multiinjection technique (MIT). Improvement of masseteric hypertrophy was assessed at week 16 using standardized measurements and photographs. Patients completed a 5-point satisfaction questionnaire while physicians completed the Global Aesthetic Improvement Scale (GAIS) and 10-point photonumeric masseter prominence rating scale.
Results: There were no significant differences in physician ratings on the photonumeric scale and GAIS between the SIT and MIT groups. Results of the standardized measurements also revealed no significant difference between injection techniques. Majority of patients at every visit reported being “satisfied” with treatment results. Clinically, the number and severity of adverse events were similar between groups.
Conclusion: This study supports the noninferiority of both SIT and MIT with regard to efficacy and safety in the management of masseteric hypertrophy, using incobotulinumtoxinA.

Keywords: Xeomin Cosmetic®, masseteric hypertrophy, noninferiority, botulinum toxin type A

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