{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:41:40Z","timestamp":1792442500834,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Botulinum toxin type A (BoNT-A) is widely used for facial rejuvenation, but patient-perceived benefit is best evaluated against an inert control. This systematic review assessed whether BoNT-A, compared with placebo, vehicle, or saline placebo, improves aesthetic self-perception and related patient-reported outcomes. PubMed\/MEDLINE, Embase, Scopus, Web of Science, and CENTRAL were searched from inception through September 25, 2026 using a sensitivity-oriented strategy. Randomized controlled trials in adults were eligible when they contained an extractable BoNT-A-versus-placebo contrast and a patient-reported aesthetic outcome. Seventy-five reports were retained: 70 contributed direct comparative evidence from 65 unique placebo-containing RCTs enrolling 18,581 participants across all randomized arms, and five linked reports were retained only for contextual mapping. Four clinically homogeneous responder subsets were quantitatively pooled; all favored BoNT-A, with pooled risk ratios ranging from 5.53 to 14.74 and I2=0% in each analysis. BoNT-A consistently improved treatment or appearance satisfaction, patient-rated facial-line severity or bother, perceived age\/youthfulness, and selected appearance-related psychosocial outcomes. Overall RoB 2 was Low in 39\/65 RCTs (60.0%) and Some concerns in 26\/65 (40.0%). GRADE certainty was moderate for satisfaction\/global aesthetic improvement, patient-reported facial-line severity\/appearance appraisal, and perceived age\/naturalness; low for appearance-related psychological well-being; and very low for general quality-of-life\/self-esteem constructs. Placebo-controlled evidence supports a consistent patient-perceived aesthetic benefit of BoNT-A, while broader psychological and quality-of-life claims remain less certain.<\/jats:p>","DOI":"10.1093\/asj\/sjag236","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:12:58Z","timestamp":1792440778000},"source":"Crossref","is-referenced-by-count":0,"title":["Patient-Reported Aesthetic Outcomes of Botulinum Toxin Type A: A Systematic Review and Meta-Analysis of Placebo-Controlled Randomized Trials"],"prefix":"10.1093","author":[{"given":"Vicente Antonio Jes\u00fas","family":"Fernandois Barrera","sequence":"first","affiliation":[{"name":"Department of Restorative Dentistry, Faculty of Dentistry, Universidad de Chile , Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiara Alexandra","family":"Maldonado Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Faculty of Dentistry, Universidad de Chile , Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Chaple-Gil","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Aut\u00f3noma de Chile , Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Basualdo Allende","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Faculty of Dentistry, Universidad de Chile , Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Maximiliano","family":"Fern\u00e1ndez Godoy","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Faculty of Dentistry, Universidad de Chile , Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,19]]},"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjag236\/72116425\/sjag236.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjag236\/72116425\/sjag236.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:12:59Z","timestamp":1792440779000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/advance-article\/doi\/10.1093\/asj\/sjag236\/8943742"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/asj\/sjag236","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"article-number":"sjag236"}}