{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:20:46Z","timestamp":1792092046732,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Platysma prominence (PP) is a common aesthetic concern associated with aging, leading to visible neck bands and loss of jawline definition. OnabotulinumtoxinA has emerged as a minimally invasive treatment; however, data from randomized controlled trials (RCTs) remain fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy and safety of onabotulinumtoxinA for treating moderate to severe PP through meta\u2010analysis of RCTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PubMed, Cochrane CENTRAL, and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      were searched from inception to March 2025 for RCTs comparing onabotulinumtoxinA with placebo in adults with PP. Two reviewers independently extracted data and assessed bias using the Cochrane RoB 2.0 tool. The primary outcomes were \u2265\u20091\u2010grade and \u2265\u20092\u2010grade improvement on the Clinician (C\u2010APPS) and Participant (P\u2010APPS) Allergan Platysma Prominence Scales. Secondary outcomes included patient satisfaction and treatment\u2010emergent adverse events (TEAEs). Random\u2010effects meta\u2010analysis was used to estimate pooled risk ratios (RRs) with 95% confidence intervals (CIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009912) were included. OnabotulinumtoxinA significantly increased \u2265\u20091\u2010grade (RR\u2009=\u20094.11; 95% CI, 3.60\u20134.69) and \u2265\u20092\u2010grade (RR\u2009=\u20091.83; 95% CI, 1.54\u20132.17) improvements compared to placebo. Patient satisfaction was higher in the treatment group (RR\u2009=\u20095.55; 95% CI, 4.15\u20137.43). The incidence of TEAEs was similar between groups (RR\u2009=\u20090.95; 95% CI, 0.76\u20131.20), with most being mild and transient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OnabotulinumtoxinA is an effective and well\u2010tolerated minimally invasive option for improving platysma prominence, offering significant aesthetic and patient\u2010reported benefits without increasing adverse effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.70701","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:11:06Z","timestamp":1769749866000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of\n                    <scp>OnabotulinumtoxinA<\/scp>\n                    for the Treatment of Platysma Prominence: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1111","volume":"25","author":[{"given":"Rahman","family":"Syed","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Swat Medical College  Swat Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameer Afzal","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saidu Medical College  Swat Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suleman","family":"Shah","sequence":"additional","affiliation":[{"name":"Fatima College of Health Sciences  Al Ain UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anfal","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saidu Medical College  Swat Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Idrees","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saidu Medical College  Swat Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsin","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Saidu Medical College  Swat Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al Sinani","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion, and Reproduction Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al Maqbali","sequence":"additional","affiliation":[{"name":"Fatima College of Health Sciences  Al Ain UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u20104725.2006.32326.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010199902000\u201000045"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000001135"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.10.027"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000011472"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032372"},{"key":"e_1_2_11_8_1","unstructured":"ClinicalTrials.gov \u201cNCT05134649. Phase 3 Extension Study Evaluating Long\u2010Term Safety of Repeated OnabotulinumtoxinA Treatments in Adult Participants With Platysma Prominence \u201d(2025) https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05134649."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjae220"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.006"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2025.2537898"},{"key":"e_1_2_11_13_1","unstructured":"\u201cReview Manager (RevMan). Version (5.4.1). The Cochrane Collaboration \u201d(2024) revman.cochrane.org."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468\u20103083.2010.03728.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003429"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjy179"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100044\u20101788284"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003491"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.70701","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.70701","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.70701","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:09:53Z","timestamp":1786021793000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.70701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jocd.70701"],"URL":"https:\/\/doi.org\/10.1111\/jocd.70701","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"assertion":[{"value":"2025-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70701"}}