Efficacy and Safety of a Novel Botulinum Toxin A for Massete
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A wide lower face and a square jaw are considered esthetic problems, particularly in Asia. A Study was conducted to investigate the optimal dose of a novel botulinum toxin (prabotulinum toxin A) for treating masseteric hypertrophy.

90 subjects with masseteric hypertrophy were randomly divided into 5 groups and treated with placebo (A, normal saline) or prabotulinum toxin A (B: 24, C: 48, D: 72, and E: 96 units). Photography, ultrasonography, and 3-dimensional imaging were performed before and after injection at baseline and at 4, 8, 12, and 16 weeks after treatment. The participants also rated their satisfaction.

Results:
--Masseter thickness significantly reduced in all groups at 12 weeks, compared with that in the placebo group.
--A dose-dependent reduction in masseter thickness was observed at the resting and maximal clenching positions.
--Sonography and 3-dimensional imaging revealed a gradual reduction in masseter thickness and volume, respectively, during the first 12 weeks.
--Despite being slightly effective, a dose of 24 units might be insufficient for resolving square face problems. Patients in Group E reported discomfort during jaw movement.

In particular, Prabotulinum toxin A could effectively improve lower face contour without major complications, with an optimal dose of 48 to 72 units, followed by reinjection after 12 weeks.

Source: https://journals.lww.com/dermatologicsurgery/Abstract/2021/01000/Efficacy_and_Safety_of_a_Novel_Botulinum_Toxin_A.15.aspx
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