{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:29:15Z","timestamp":1779316155895,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Botulinum toxin type A (BoNT\u2010A) injection remains the leading medical cosmetic procedure worldwide, with a high rate of patient satisfaction. However, it still suffers from patients\u2019 fear of being unable to transmit their emotions and of looking frozen from unnatural results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to determine whether BoNT\u2010A can decrease the intensity of emotions in facial expressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>In this single\u2010center prospective study, 42 patient investigators assessed four patients\u2019 facial expressions for six emotions and neutral faces, before and after injection of 36\u00a0IU or 48\u00a0IU of onabotulinumtoxinA, using photographs. Photographs were presented on a tablet to the investigators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no statistical differences between the before and after photographs for the intensity of emotions for all expressions (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a0.05) except for the expression of surprise in the group of patients that received 48\u00a0IU of the injection (protocol with injection of the frontalis muscle). All patient investigators answered negatively to the question \u201cDo you think that this patient has a \u2018frozen face\u2019?\u201d.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows that esthetic injection of BoNT\u2010A in the upper face has no negative effects on facial expressions and does not lead to the feared \u201cfrozen face\u201d when it is injected with respect for best practice guidelines. This study can be used as an example for patients who have some reticences against BoNT\u2010A injection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13980","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T17:57:44Z","timestamp":1612547864000},"page":"1405-1410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Influence of botulinum toxin type A esthetic injections on facial expressions"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-5535","authenticated-orcid":false,"given":"R\u00e9mi","family":"Foissac","sequence":"first","affiliation":[{"name":"Plastic and reconstructive Surgery Clinique Saint George Nice France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc J.","family":"Benatar","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive Surgery Clinique Santa Maria Nice France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12815"},{"key":"e_1_2_7_3_1","unstructured":"The American Society for Aesthetic Plastic Survey.Cosmetic Surgery National Data Bank Statistics.2017. Available from:https:\/\/www.surgery.org\/sites\/default\/files\/ASAPS\u2010Stats2017.pdf. Accessed March 21 2019."},{"key":"e_1_2_7_4_1","unstructured":"The American Society of Plastic Surgeons: 2016 Plastic Surgery Statistics Report. Available at:http:\/\/www.plasticsurgery.org\/Documents\/news\u2010resources\/statistics\/2016\u2010statistics\/plasticsurgery\u2010statsitics\u2010full\u2010report.pdf. Accessed March 12 2019."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2009.0189"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2013.09.009"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000475758.63709.23"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181b5641b"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2009.03475.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2011.02075.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2006.32327.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.03.049"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfacial.2009.5"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2009.01235.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000805"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000002758"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31816de8d0"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjx005"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-2165.2011.00593.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001991"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001277"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.10.059"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.10.060"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12729"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13980","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.13980","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.13980","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T11:25:55Z","timestamp":1693567555000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.13980"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,12]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1111\/jocd.13980"],"URL":"https:\/\/doi.org\/10.1111\/jocd.13980","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,12]]},"assertion":[{"value":"2020-11-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}