{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T02:00:06Z","timestamp":1781661606067,"version":"3.54.5"},"reference-count":59,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"Importance<\/jats:title>Multiple botulinum toxin A formulations were approved by the US Food and Drug Administration for treating the glabellar rhytids. A comparative quantitative evaluation of their effects on the glabella has not been conducted.<\/jats:p><\/jats:sec>Objective<\/jats:title>To provide an objective quantitative assessment of the effect of 4 botulinum toxin A formulations on glabellar strain across using dynamic 3-dimensional photogrammetry.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This single-center, double-blind clinical trial, conducted at the University of Pennsylvania Division of Plastic Surgery clinic, randomized 143 female individuals aged 30 to 65 years into 4 arms receiving different botulinum toxin A formulations on day 0 and with follow-up at days 3, 30, 90, and 180. Dynamic 3-dimensional photogrammetry and surveys were collected from March 2022 to June 2023 and analyzed from July 2023 to April 2024.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Participants were randomized 1:1:1:1 into 4 treatment arms: 1 dose of 20 units of onabotulinum toxin A (OBoNT\/A); 1 dose of 50 units of abobotulinum toxin A (ABoNT\/A); 1 dose of 20 units of prabotulinum toxin A (PBoNT\/A); or 1 dose of 20 units of incobotulinum toxin A (IBoNT\/A) into the glabellar region (GR).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was change in GR dynamic strain after injection over time. Secondary outcomes included changes in patient-reported satisfaction, the relationship between baseline strain severity and postinjection improvement in strain, and the effect on the strain of the untreated lateral canthal region.<\/jats:p><\/jats:sec>Results<\/jats:title>This study recruited 143 female individuals with a mean (SD) age of 43.5 (9.8) years. ABoNT\/A and PBoNT\/A had the fastest onset at day 3. PBoNT\/A and IBoNT\/A retained efficacy at day 180 compared with their baseline. Increasing baseline glabellar strain severity resulted in increased improvement with treatment. Lateral canthal region strain increased with decreasing GR strain. PBoNT\/A was significantly more effective at day 180 than OBoNT\/A. All arms experienced improvement in related FACE-Q module scores up to 90 days.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This randomized clinical trial found that ABoNT\/A and PBoNT\/A displayed the most rapid onset of effect. The peak effect is similar across all toxins. When measuring strain at approximately 6 months, some toxins remain significant relative to their own baseline or compared with other specific toxins.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT05167864<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2025.1335","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T11:31:05Z","timestamp":1748431865000},"page":"723","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of Botulinum Toxin A Formulations for Glabellar Strain Treatment in Women"],"prefix":"10.1001","volume":"161","author":[{"given":"Mehdi S.","family":"Lemdani","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie E.","family":"Honig","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore E.","family":"Habarth-Morales","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison D.","family":"Davis","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen F.","family":"Niu","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane N.","family":"Ewing","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn B.","family":"Broach","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Serletti","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivona","family":"Percec","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"12","key":"doi250018r2","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1097\/DSS.0000000000003211","article-title":"Progressive improvement in static glabellar lines after repeated treatment with daxibotulinumtoxina for injection.","volume":"47","author":"Glogau","year":"2021","journal-title":"Dermatol Surg"},{"key":"doi250018r3","doi-asserted-by":"publisher","DOI":"10.1093\/asjof\/ojae010","article-title":"Efficacy and safety of letibotulinumtoxina in the treatment of moderate and severe glabellar lines in females 35 to 50 years of age: post hoc analyses of the phase 3 clinical study data.","volume":"6","author":"Gold","year":"2024","journal-title":"Aesthet Surg J Open Forum"},{"issue":"5","key":"doi250018r4","first-page":"47","article-title":"OnabotulinumtoxinA versus prabotulinumtoxinA-xvfs: a randomized, triple-blind, split-face study on the time to onset, rhytid appearance, and patient satisfaction in forehead and glabellar 9lines.","volume":"16","author":"Vasile","year":"2023","journal-title":"J Clin Aesthet Dermatol"},{"issue":"10","key":"doi250018r5","doi-asserted-by":"publisher","first-page":"985","DOI":"10.36849\/JDD.2020.5454","article-title":"IncobotulinumtoxinA demonstrates safety and prolonged duration of effect in a dose-ranging study for glabellar lines.","volume":"19","author":"Kerscher","year":"2020","journal-title":"J Drugs Dermatol"},{"issue":"2","key":"doi250018r6","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1097\/IOP.0000000000002491","article-title":"Efficacy and safety of abobotulinumtoxinA for treatment of moderate-to-severe glabellar lines: a meta-analysis.","volume":"40","author":"Han","year":"2024","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"doi250018r7","article-title":"Diffusion of botulinum toxins.","volume":"2","author":"Brodsky","year":"2012","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"doi250018r8","doi-asserted-by":"publisher","first-page":"273","DOI":"10.2147\/CCID.S156851","article-title":"Botulinum neurotoxin formulations: overcoming the confusion.","volume":"11","author":"Samizadeh","year":"2018","journal-title":"Clin Cosmet Investig Dermatol"},{"issue":"2 Spec No.","key":"doi250018r9","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/j.1524-4725.2011.02248.x","article-title":"Validated assessment scales for the upper face.","volume":"38","author":"Flynn","year":"2012","journal-title":"Dermatol Surg"},{"issue":"1","key":"doi250018r10","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.36849\/JDD.7194","article-title":"Optimized patient outcomes with the novel modality of corrective chemical peel and neurotoxin on same-day treatment.","volume":"23","author":"Roberts","year":"2024","journal-title":"J Drugs Dermatol"},{"issue":"5","key":"doi250018r11","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1097\/PRS.0000000000001255","article-title":"A prospective, split-face, randomized, double-blind study comparing onabotulinumtoxinA to incobotulinumtoxinA for upper face wrinkles.","volume":"135","author":"Yeilding","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"doi250018r12","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1097\/DSS.0000000000000757","article-title":"Duration of clinical efficacy of onabotulinumtoxinA in crow\u2019s feet lines: results from two multicenter, randomized, controlled trials.","volume":"42","author":"Baumann","year":"2016","journal-title":"Dermatol Surg"},{"key":"doi250018r13","doi-asserted-by":"publisher","first-page":"449","DOI":"10.2147\/CIA.S34854","article-title":"Onset, longevity, and patient satisfaction with incobotulinumtoxinA for the treatment of glabellar frown lines: a single-arm, prospective clinical study.","volume":"8","author":"Prager","year":"2013","journal-title":"Clin Interv Aging"},{"issue":"8","key":"doi250018r14","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1097\/DSS.0000000000000424","article-title":"Subject satisfaction with onabotulinumtoxinA treatment of glabellar and lateral canthal lines using a new patient-reported outcome measure.","volume":"41","author":"Rivers","year":"2015","journal-title":"Dermatol Surg"},{"issue":"1","key":"doi250018r15","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1007\/s00266-018-1230-y","article-title":"Three-dimensional evaluation of static and dynamic effects of botulinum toxin A on glabellar frown lines.","volume":"43","author":"Rappl","year":"2019","journal-title":"Aesthetic Plast Surg"},{"issue":"4","key":"doi250018r16","doi-asserted-by":"publisher","first-page":"735e","DOI":"10.1097\/PRS.0b013e318245e74e","article-title":"Objective quantification of wrinkles: three-dimensional analysis of surface irregularity.","volume":"129","author":"Lumenta","year":"2012","journal-title":"Plast Reconstr Surg"},{"issue":"11","key":"doi250018r17","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1093\/asj\/sjy060","article-title":"Perioral rejuvenation: a prospective, quantitative dynamic three-dimensional analysis of a dual modality treatment.","volume":"38","author":"Chang","year":"2018","journal-title":"Aesthet Surg J"},{"issue":"2","key":"doi250018r18","doi-asserted-by":"publisher","first-page":"295e","DOI":"10.1097\/PRS.0000000000006461","article-title":"An objective, quantitative, dynamic assessment of hyaluronic acid fillers that adapt to facial movement.","volume":"145","author":"Percec","year":"2020","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"doi250018r19","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1093\/asj\/sjy205","article-title":"A 3D morphometrical evaluation of brow position after standardized botulinum toxin A treatment of the forehead and glabella.","volume":"39","author":"Schlager","year":"2019","journal-title":"Aesthet Surg J"},{"issue":"7","key":"doi250018r20","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3349\/ymj.2022.0605","article-title":"Dynamic evaluation of skin displacement by the frontalis muscle contraction using three-dimensional skin displacement vector analysis.","volume":"64","author":"Kwon","year":"2023","journal-title":"Yonsei Med J"},{"issue":"5","key":"doi250018r21","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1097\/PRS.0000000000002076","article-title":"A quantitative analysis of onabotulinumtoxinA, abobotulinumtoxinA, and incobotulinumtoxinA: a randomized, double-blind, prospective clinical trial of comparative dynamic strain reduction.","volume":"137","author":"Wilson","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"5","key":"doi250018r22","doi-asserted-by":"publisher","first-page":"869e","DOI":"10.1097\/PRS.0000000000001224","article-title":"Digital image correlation: a novel dynamic three-dimensional imaging technique for precise quantification of the dynamic rhytid and botulinum toxin type a efficacy.","volume":"135","author":"Wilson","year":"2015","journal-title":"Plast Reconstr Surg"},{"issue":"7","key":"doi250018r23","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1093\/asj\/sjv244","article-title":"Patient perceived benefit in facial aesthetic procedures: FACE-Q as a tool to study botulinum toxin injection outcomes.","volume":"36","author":"Chang","year":"2016","journal-title":"Aesthet Surg J"},{"issue":"5","key":"doi250018r24","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1111\/jocd.14858","article-title":"Efficacy of botulinum toxin in masseter muscle hypertrophy for lower face contouring.","volume":"21","author":"Kundu","year":"2022","journal-title":"J Cosmet Dermatol"},{"issue":"4","key":"doi250018r25","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1097\/PRS.0000000000002004","article-title":"A comparative assessment of three formulations of botulinum toxin type A for facial rhytides: a systematic review with meta-analyses.","volume":"137","author":"Bonaparte","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"7","key":"doi250018r26","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1097\/DSS.0000000000001076","article-title":"Incobotulinumtoxina for aesthetic indications: a systematic review of prospective comparative trials.","volume":"43","author":"Prager","year":"2017","journal-title":"Dermatol Surg"},{"issue":"12","key":"doi250018r27","first-page":"E56","article-title":"Onset and duration of abobotulinumtoxinA for aesthetic use in the upper face: a systematic literature review.","volume":"13","author":"Nestor","year":"2020","journal-title":"J Clin Aesthet Dermatol"},{"issue":"2","key":"doi250018r28","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1093\/asj\/sjac253","article-title":"The efficacy and duration of onabotulinum toxin A in improving upper facial expression lines with 64-unit dose optimization: a systematic review and meta-analysis with trial sequential analysis of the randomized controlled trials.","volume":"43","author":"Rahman","year":"2023","journal-title":"Aesthet Surg J"},{"issue":"2","key":"doi250018r30","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"doi250018r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners.","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"4","key":"doi250018r33","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1001\/jamadermatol.2016.0018","article-title":"Development and psychometric validation of the FACE-Q skin, lips, and facial rhytids appearance scales and adverse effects checklists for cosmetic procedures.","volume":"152","author":"Klassen","year":"2016","journal-title":"JAMA Dermatol"},{"issue":"11","key":"doi250018r35","doi-asserted-by":"publisher","first-page":"2785","DOI":"10.1111\/jocd.13702","article-title":"The mechanisms of action and use of botulinum neurotoxin type A in aesthetics: key clinical postulates II.","volume":"19","author":"Nestor","year":"2020","journal-title":"J Cosmet Dermatol"},{"issue":"9","key":"doi250018r36","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000000185","article-title":"Quantified facial soft-tissue strain in animation measured by real-time dynamic 3-dimensional imaging.","volume":"2","author":"Hsu","year":"2014","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"doi250018r37","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.1093\/asj\/sjac002","article-title":"Impact of glabellar injection technique with daxibotulinumtoxina for injection on brow position.","volume":"43","author":"Bertucci","year":"2023","journal-title":"Aesthet Surg J"},{"issue":"2","key":"doi250018r38","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3341\/kjo.2015.29.2.115","article-title":"Clinical outcomes of individualized botulinum neurotoxin type A injection techniques in patients with essential blepharospasm.","volume":"29","author":"Sung","year":"2015","journal-title":"Korean J Ophthalmol"},{"issue":"2","key":"doi250018r39","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3390\/toxins15020082","article-title":"Cosmetic treatment using botulinum toxin in the oral and maxillofacial area: a narrative review of esthetic techniques.","volume":"15","author":"Hong","year":"2023","journal-title":"Toxins (Basel)"},{"issue":"6","key":"doi250018r40","doi-asserted-by":"publisher","first-page":"NP500","DOI":"10.1093\/asj\/sjaa220","article-title":"A double-blind, randomized clinical trial to determine effects of increasing doses and dose-response relationship of incobotulinumtoxinA in the treatment of glabellar rhytids.","volume":"41","author":"Polacco","year":"2021","journal-title":"Aesthet Surg J"},{"issue":"1","key":"doi250018r41","doi-asserted-by":"publisher","first-page":"88","DOI":"10.4103\/JCAS.JCAS_20_20","article-title":"A retrospective study supporting the importance of individualizing the dose of botulinum toxin according to the age.","volume":"14","author":"Bravo","year":"2021","journal-title":"J Cutan Aesthet Surg"},{"issue":"12","key":"doi250018r42","first-page":"1544","article-title":"Does increasing the dose of abobotulinumtoxina impact the duration of effectiveness for the treatment of moderate to severe glabellar lines?","volume":"15","author":"Joseph","year":"2016","journal-title":"J Drugs Dermatol"},{"key":"doi250018r43","doi-asserted-by":"publisher","first-page":"S110","DOI":"10.1097\/01.DSS.0000452645.76270.88","article-title":"Fields of muscular and anhidrotic effects of 2 botulinum toxin-A commercial preparations: a prospective, double-blind, randomized, multicenter study.","volume":"41","author":"Hexsel","year":"2015","journal-title":"Dermatol Surg"},{"issue":"3","key":"doi250018r44","doi-asserted-by":"publisher","first-page":"e91","DOI":"10.1097\/DSS.0000000000002789","article-title":"Efficacy and safety of a new botulinum toxin (HU-014) versus existing onabotulinumtoxin A in subjects with moderate to severe glabellar lines.","volume":"47","author":"Yoo","year":"2021","journal-title":"Dermatol Surg"},{"issue":"3","key":"doi250018r45","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/SAP.0b013e3181cbfee6","article-title":"The quantitative assessment of wrinkle depth: turning the microscope on botulinum toxin type A.","volume":"65","author":"Branford","year":"2010","journal-title":"Ann Plast Surg"},{"issue":"5","key":"doi250018r46","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1007\/s13555-024-01177-1","article-title":"Comparative study on the duration and efficacy of various botulinum toxin type A injections for reducing masseteric muscle bite force and treating facial wrinkles.","volume":"14","author":"Sirisuthivoranunt","year":"2024","journal-title":"Dermatol Ther (Heidelb)"},{"issue":"9","key":"doi250018r47","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1093\/asj\/sjae051","article-title":"Safety and duration of effect of 40-unit prabotulinumtoxinA-xvfs for the treatment of moderate to severe glabellar lines in adult patients: a phase II, multicenter, randomized, double-blind, active-controlled trial.","volume":"44","author":"Fagien","year":"2024","journal-title":"Aesthet Surg J"},{"key":"doi250018r48","doi-asserted-by":"publisher","first-page":"581","DOI":"10.2147\/CCID.S397999","article-title":"A preclinical study comparing the activity and potency of onabotulinumtoxina and prabotulinumtoxina.","volume":"16","author":"Rupp","year":"2023","journal-title":"Clin Cosmet Investig Dermatol"},{"issue":"12","key":"doi250018r49","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1093\/asj\/sjac210","article-title":"PrabotulinumtoxinA vs onabotulinumtoxinA for the treatment of adult males with moderate to severe glabellar lines: post-hoc analyses of the phase III clinical study data.","volume":"42","author":"Solish","year":"2022","journal-title":"Aesthet Surg J"},{"issue":"2","key":"doi250018r50","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/ijd.12627","article-title":"Comparative trial of a novel botulinum neurotoxin type A versus onabotulinumtoxinA in the treatment of glabellar lines: a multicenter, randomized, double-blind, active-controlled study.","volume":"54","author":"Won","year":"2015","journal-title":"Int J Dermatol"},{"issue":"6","key":"doi250018r51","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1007\/s00266-018-1200-4","article-title":"Assessment of subject and physician satisfaction after long-term treatment of glabellar lines with abobotulinumtoxinA (Dysport\/Azzalure): primary results of the APPEAL noninterventional study.","volume":"42","author":"Gubanova","year":"2018","journal-title":"Aesthetic Plast Surg"},{"issue":"7","key":"doi250018r52","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1111\/jdv.12881","article-title":"Patient satisfaction after the treatment of glabellar lines with Botulinum toxin type A (Speywood unit): a multi-centre European observational study.","volume":"29","author":"Molina","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"4","key":"doi250018r53","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1097\/DSS.0000000000002846","article-title":"A multicenter study to evaluate subject satisfaction with two treatments of abobotulinumtoxina a year in the glabellar lines.","volume":"47","author":"Schlessinger","year":"2021","journal-title":"Dermatol Surg"},{"issue":"8","key":"doi250018r54","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1097\/DSS.0000000000001523","article-title":"Prospective cohort study investigating changes in body image, quality of life, and self-esteem following minimally invasive cosmetic procedures.","volume":"44","author":"Sobanko","year":"2018","journal-title":"Dermatol Surg"},{"issue":"9","key":"doi250018r55","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1093\/asj\/sjz248","article-title":"Significantly increased patient satisfaction following liquid formulation abobotulinumtoxinA treatment in glabellar lines: FACE-Q outcomes from a phase 3 clinical trial.","volume":"40","author":"Ascher","year":"2020","journal-title":"Aesthet Surg J"},{"issue":"7","key":"doi250018r56","doi-asserted-by":"publisher","first-page":"2380","DOI":"10.1111\/jocd.16289","article-title":"Evaluation of people\u2019s satisfaction with botulinum toxin injection for facial rejuvenation based on age.","volume":"23","author":"Farashi","year":"2024","journal-title":"J Cosmet Dermatol"},{"issue":"10","key":"doi250018r57","doi-asserted-by":"publisher","first-page":"606","DOI":"10.11622\/smedj.2016112","article-title":"Efficacy and patient satisfaction with incobotulinumtoxinA for the treatment of glabellar frown lines.","volume":"58","author":"Lim","year":"2017","journal-title":"Singapore Med J"},{"issue":"12","key":"doi250018r58","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1097\/DSS.0000000000001679","article-title":"Efficacy, safety, and subject satisfaction after abobotulinumtoxina treatment of upper facial lines.","volume":"44","author":"Hexsel","year":"2018","journal-title":"Dermatol Surg"},{"issue":"9","key":"doi250018r59","doi-asserted-by":"publisher","first-page":"1506","DOI":"10.1111\/j.1524-4725.2012.02505.x","article-title":"Glabellar contraction patterns: a tool to optimize botulinum toxin treatment.","volume":"38","author":"de Almeida","year":"2012","journal-title":"Dermatol Surg"},{"key":"doi250018r34","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2024"},{"key":"doi250018r1","unstructured":"American Society of Plastic Surgeons. Plastic surgery statistics. Accessed May 3, 2024. https:\/\/www.plasticsurgery.org\/news\/plastic-surgery-statistics"},{"key":"doi250018r29","unstructured":"Urbaniak? GC, Plous? S. Research randomizer (version 4.0). Accessed November 2, 2023. https:\/\/www.randomizer.org\/"},{"key":"doi250018r32","unstructured":"US Food and Drug Administration. Drugs@FDA: FDA-approved drugs. Accessed January 20, 2025. https:\/\/www.accessdata.fda.gov\/scripts\/cder\/daf\/index.cfm?event=overview.process&ApplNo=103000"}],"container-title":["JAMA Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/articlepdf\/2834687\/jamadermatology_lemdani_2025_oi_250018_1755268739.87204.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T15:00:39Z","timestamp":1755702039000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamadermatology\/fullarticle\/2834687"}},"subtitle":["A Double-Blind Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":59,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamadermatol.2025.1335","relation":{},"ISSN":["2168-6068"],"issn-type":[{"value":"2168-6068","type":"print"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}