{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:20:07Z","timestamp":1791303607628,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"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":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Botulinum neurotoxin type A is the most widely used nonsurgical treatment for esthetic improvement of the face and neck. In 2015, an Italian consensus panel met to discuss the optimal methods for using onabotulinumtoxinA. However, clinical practice continues to evolve and the original report is now considered obsolete.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To provide updated guidance on the esthetic uses of onabotulinumtoxinA in the face and neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A panel of 10 Italian specialists (including plastic and maxillofacial surgeons, dermatologists, and esthetic doctors) individually completed a questionnaire on their own clinical practice, and then met to discuss their responses and agree on a revised treatment consensus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recommendations are provided on patient assessment, reconstitution of onabotulinumtoxinA, and preferred procedures (injection sites, doses, anatomical targets, safety precautions, etc.) across a variety of treatment areas, including glabellar, crow's feet, and forehead lines; brow lifting and shaping; lower eyelid hypertrophy; bunny lines; sagging nasal tip; gummy smile; masseter hypertrophy; perioral lines; marionette lines and \u201csad mouth;\u201d mentalis hypertonia; and platysma bands. Some of the recommended doses are substantially increased from the previous consensus (particularly in the upper third and masseter) for the purpose of achieving longer lasting results without affecting safety. Furthermore, two increasingly popular techniques\u2014the Nefertiti lift and Microbotox\u2014are included in the consensus for the first time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Optimal practice with onabotulinumtoxinA requires a systematic approach to maximize safety and effectiveness across the range of potential uses. The present consensus was developed to support these aims.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14728","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T06:56:09Z","timestamp":1642748169000},"page":"550-563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["OnabotulinumtoxinA from lines to facial reshaping: A new Italian consensus report"],"prefix":"10.1111","volume":"21","author":[{"given":"Massimo","family":"Signorini","sequence":"first","affiliation":[{"name":"Private Practice  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Piero Fundar\u00f2","sequence":"additional","affiliation":[{"name":"Multimed  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8635-9967","authenticated-orcid":false,"given":"Dario","family":"Bertossi","sequence":"additional","affiliation":[{"name":"Section of Oral and Maxillofacial Surgery Department of Surgical Sciences University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Cavallini","sequence":"additional","affiliation":[{"name":"Private Practice  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfrancesco","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Private Practice  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Natuzzi","sequence":"additional","affiliation":[{"name":"San Camillo Forlanini Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Quartucci","sequence":"additional","affiliation":[{"name":"Private Practice  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Sciuto","sequence":"additional","affiliation":[{"name":"Private Practice  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariagrazia","family":"Patalano","sequence":"additional","affiliation":[{"name":"Private Practice  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Trocchi","sequence":"additional","affiliation":[{"name":"Private Practice  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"American Society of Plastic Surgeons.National plastic surgery statistics 2020.www.plasticsurgery.org\/documents\/News\/Statistics\/2020\/plastic\u2010surgery\u2010statistics\u2010report\u20102020.pdf. Accessed September 2 2021."},{"key":"e_1_2_11_3_1","unstructured":"International Society of Aesthetic Plastic Surgery.ISAPS international survey on aesthetic\/cosmetic procedures performed in 2019.www.isaps.org\/wp\u2010content\/uploads\/2020\/12\/Global\u2010Survey\u20102019.pdf. Accessed September 2 2021."},{"key":"e_1_2_11_4_1","first-page":"45","article-title":"Italian consensus report on the esthetic use of onabotulinumtoxinA","volume":"18","author":"Bertossi D","year":"2016","journal-title":"Esperienze Dermatologiche"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12729"},{"key":"e_1_2_11_6_1","unstructured":"Vistabel.Summary of product characteristics.www.medicines.ie\/medicines\/Vistabel\u201034207\/spc. Accessed September 2 2021."},{"key":"e_1_2_11_7_1","volume-title":"2020 American Society for Dermatologic Surgery Annual Meeting","author":"Cox SE","year":"2020"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13130"},{"key":"e_1_2_11_9_1","volume-title":"Manual of Aesthetic Surgery","author":"Werner M","year":"2011"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.1330080113"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"35S","DOI":"10.1177\/1090820X13480479","article-title":"Consensus panel's assessment and recommendations on the use of 3 botulinum toxin type A products in facial aesthetics","volume":"33","author":"Lorenc ZP","year":"2013","journal-title":"Aesthet Surg J"},{"key":"e_1_2_11_12_1","first-page":"19","article-title":"The male aesthetic patient: facial anatomy, concepts of attractiveness, and treatment patterns","volume":"17","author":"Keaney TC","year":"2018","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31816aaad4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dsu.12148"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2011.02284.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.13522"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04066.x"},{"key":"e_1_2_11_18_1","first-page":"13","article-title":"Botulinum toxin type A reconstituted in lidocaine with epinephrine for facial rejuvenation: results of a participant satisfaction survey","author":"Kim A","year":"2013","journal-title":"Cutis"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X14532941"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000002758"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2013.9.3.157"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1242\/jcs.146324"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003544"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000626"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001414"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001612"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002669"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2019.07.014"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjaa366"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jobcr.2021.02.006"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000003716"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2019.12.003"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-018-1116-z"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-020-01825-9"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins9010014"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005944"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/14764170701545657"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003646"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001135"},{"key":"e_1_2_11_40_1","volume-title":"Regional Conference in Dermotological Laser and Facial Cosmetic Surgery 2002","author":"Wu WTL","year":"2002"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000001827"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-013-8423-9"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjaa168"},{"key":"e_1_2_11_44_1","first-page":"81","article-title":"Different aspects of informed consent in aesthetic surgeries","volume":"3","author":"Nejadsarvari N","year":"2014","journal-title":"World J Plast Surg"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.14728","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.14728","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.14728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T10:34:05Z","timestamp":1692268445000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.14728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,20]]},"references-count":43,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1111\/jocd.14728"],"URL":"https:\/\/doi.org\/10.1111\/jocd.14728","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,20]]},"assertion":[{"value":"2021-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}