Botulinum Toxin Type A Injection for Mammoplasty and Abdominoplasty Scar Management: A Split-Scar Double-Blinded Randomized Controlled Study

Abstract

Background Scars are inevitable results of surgical procedures, and prevention of them is still a major problem in the field of cosmetic surgery. Although various studies have been performed on botulinum toxin-A (BoNT-A) injection for the prevention of hypertrophic scars, the exact mechanism remains unclear. Methods This prospective, double-blinded, randomized study was performed on 19 patients who underwent mammoplasty and abdominoplasty surgery in Razi Hospital from October 2018 to December 2019. Single session of treatment was performed, where XEOMIN was allocated to one half of the scar and 0.9% saline to the control half. 3 and 6 months later, scars were assessed using the modified Stony Brook Scar Evaluation Scale (SBSES). Results In total, 19 patients who completed the study were analyzed. mSBSES at the third month (P value \ 0.001; 3.34 ± 1.59 vs 1.5 ± 1.36) and the sixth month (P value \ 0.001; 4.89 ± 1.83 vs 2.39 ± 1.82) showed a significant difference between the treatment and control groups. In the subset analysis, there was significant difference between BoNT-A and control in all four items including width, height, color, and scar visibility at months 3 and 6, and the BoNT-A-treated sides had higher scores in all items. Conclusion BoNT-A has a significant effect on scar prevention due to mammoplasty and abdominoplasty compared to placebo and results in decreased erythema, height, width and reduces incision line visibility. Moreover, its effect increases significantly over time from months 3 to 6.

Efficacy and safety of botulinum toxin type A for postoperative scar prevention and wound healing improvement: A systematic review and meta‐analysis

“…All studies took post‐surgical wounds as intervention objects. Ten of them treated facial scars, 30–33,35–40 along with two studies treating thyroidectomy incisions, 41,42 one study treating median sternotomy wounds, 43 and one study treating mammoplasty and abdominoplasty wounds 44 . Seven studies were self‐control trials, 34,36,37,40,42–44 adopting whether split‐scar design or contralateral‐control design.…”

“…Ten of them treated facial scars, 30–33,35–40 along with two studies treating thyroidectomy incisions, 41,42 one study treating median sternotomy wounds, 43 and one study treating mammoplasty and abdominoplasty wounds 44 . Seven studies were self‐control trials, 34,36,37,40,42–44 adopting whether split‐scar design or contralateral‐control design. Fourteen studies presented results of 6‐month follow‐up, 30,31,33–39,41–45 and three studies also reported results of longer follow‐up 32,34,40 …”

“…Seven studies were self‐control trials, 34,36,37,40,42–44 adopting whether split‐scar design or contralateral‐control design. Fourteen studies presented results of 6‐month follow‐up, 30,31,33–39,41–45 and three studies also reported results of longer follow‐up 32,34,40 …”

“…All studies mentioned participants going through the randomization procedure, but four of them failed to describe a specific randomization approach 30–32,35 . Six studies did not explain allocation procedure, 30–33,35,44 while the rest 10 studies accomplished allocation concealment. Blinding of participants and personnel involved in surgery, injection, or outcome assessments was performed in all studies.…”

Photocrosslinking silver nanoparticles–aloe vera–silk fibroin composite hydrogel for treatment of full-thickness cutaneous wounds

“…Scars are inevitable results of surgical procedures, and their prevention is still a major problem in the field of cosmetic surgery [ 50 ]. More importantly, the balance between the four primary steps of wound healing determines the dynamics of regeneration, and the outcome of wound healing, in particular, scar formation [ 51 ].…”