{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:04:16Z","timestamp":1791007456223,"version":"4.1.0"},"reference-count":17,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"A.I.T.E.B","award":["not applicable"],"award-info":[{"award-number":["not applicable"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Background: Patient care following botulinum toxin injections has long been guided by anecdotal instructions, often based on theoretical considerations. This study evaluates the necessity of extended post-treatment instructions by analyzing outcomes and satisfaction in patients who followed only a 10 min precaution protocol. Materials and Methods: A retrospective, multicentric study was conducted across six Italian centers, analyzing 5014 patients treated with botulinum toxin for upper facial wrinkles between 2015 and 2020. Outcomes included adverse effects\u2014particularly upper eyelid ptosis\u2014and patient satisfaction. Follow-up was performed at two weeks. Results: No cases of upper eyelid ptosis were observed. Among 4000 patients who attended follow-up, adverse effects occurred in only 5.99%, notably lower than rates reported in the literature. Of the 2010 patients who completed the satisfaction questionnaire, 90% reported being very satisfied. These findings support the safety of limiting post-treatment instructions to 10 min. Conclusions: Our findings indicate that omitting extended post-injection instructions does not negatively impact patient satisfaction or complication rates. Given the toxin\u2019s rapid internalization and localized effect, extended behavioral restrictions may be redundant. However, the absence of a control group and lack of statistical analyses limit the strength of these conclusions. In addition, this is a short-term study. Future prospective, randomized trials are needed to develop evidence-based post-care protocols to optimize esthetic outcomes, patient safety, and long-term efficacy.<\/jats:p>","DOI":"10.3390\/toxins17080372","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T08:51:33Z","timestamp":1753692693000},"page":"372","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Are Post-Care Recommendations Following Upper-Face Botulinum Toxin Treatment Scientifically Necessary? A Retrospective Study Based on 5000 Patients"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0500-461X","authenticated-orcid":false,"given":"Adriano","family":"Santorelli","sequence":"first","affiliation":[{"name":"\u201cSantorelli and Partners\u201d, Via Raffaele Morghen, 88, 80129 Napoli, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Salti","sequence":"additional","affiliation":[{"name":"Independent Researcher, Via Claudio Monteverdi, 2, 50144 Firenze, FI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Cavallini","sequence":"additional","affiliation":[{"name":"Agor\u00e0, Via dei Ciclamini, 23, 20147 Milano, MI, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8152-197X","authenticated-orcid":false,"given":"Salvatore Piero","family":"Fundar\u00f2","sequence":"additional","affiliation":[{"name":"Independent Researcher, Viale Schiocchi, 40, 41124 Modena, MO, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Basso","sequence":"additional","affiliation":[{"name":"Independent Researcher, Via Galata, 37\/4, 16121 Genova, GE, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1109-4209","authenticated-orcid":false,"given":"Martina","family":"Ponzo","sequence":"additional","affiliation":[{"name":"Residency Program in Plastic, Reconstructive and Aesthetic Surgery, Campus Biomedico University, Via \u00c1lvaro del Portillo, 21, 00128 Roma, RM, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6002-6454","authenticated-orcid":false,"given":"Stefano","family":"Avvedimento","sequence":"additional","affiliation":[{"name":"\u201cOspedale Cardarelli\u201d, Via Antonio Cardarelli, 9, 80131 Napoli, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9459-9256","authenticated-orcid":false,"given":"Stefano","family":"Uderzo","sequence":"additional","affiliation":[{"name":"\u201cSantorelli and Partners\u201d, Via Raffaele Morghen, 88, 80129 Napoli, NA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","unstructured":"Allergan Pharmaceuticals (Ireland) Ltd (2002). Botulinum Toxin Cosmetic (Botulinum Toxin Type A for Injection) Purified Neurotoxin Complex, Allergan. Product monograph."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.neuroscience.2017.03.049","article-title":"Botulinum neurotoxin type A-cleaved SNAP25 is confined to primary motor neurons and localized on the plasma membrane following intramuscular toxin injection","volume":"352","author":"Cai","year":"2017","journal-title":"Neuroscience"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kumar, R., and Singh, B.R. (2025). Botulinum Toxin: A Comprehensive Review of Its Molecular Architecture and Mechanistic Action. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26020777"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/j.asj.2009.09.014","article-title":"The science and manufacturing behind botulinum neurotoxin type A-ABO in clinical use","volume":"29","author":"Wortzman","year":"2009","journal-title":"Aesthetic Surg. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/jocd.15468","article-title":"Locking the line of convergence by botulinum toxin type A for the treatment of dynamic forehead wrinkles","volume":"22","author":"Eid","year":"2023","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0733-8635(03)00071-8","article-title":"Botulinum toxin type A for the treatment of glabellar rhytides","volume":"22","author":"Carruthers","year":"2004","journal-title":"Dermatol. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/ajd.13273","article-title":"Facial aesthetic injections in clinical practice: Pretreatment and posttreatment consensus recommendations to minimise adverse outcomes","volume":"61","author":"Goodman","year":"2020","journal-title":"Australas. J. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"240","DOI":"10.12968\/joan.2018.7.5.240","article-title":"Post-treatment advice following botulinum toxin injections: A review","volume":"7","author":"Patel","year":"2018","journal-title":"J. Aesthetic Nurs."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/164_2019_271","article-title":"The History of Botulinum Toxins in Medicine: A Thousand Year Journey","volume":"263","author":"Whitcup","year":"2021","journal-title":"Handb. Exp. Pharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.toxicon.2015.07.013","article-title":"Explanation of timing of botulinum neurotoxin effects, onset and duration, and clinical ways of influencing them","volume":"107 Pt A","author":"Hallett","year":"2015","journal-title":"Toxicon"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.toxicon.2015.06.021","article-title":"In vivo onset and duration of action varies for botulinum neurotoxin A subtypes 1-5","volume":"107 Pt A","author":"Pellett","year":"2015","journal-title":"Toxicon"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"NP150","DOI":"10.1093\/asj\/sjy300","article-title":"Continuing Myths About Botulinum Toxin Use in Aesthetics Are Unhelpful and Unnecessary","volume":"39","author":"Pickett","year":"2019","journal-title":"Aesthetic Surg. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s00266-016-0682-1","article-title":"Adverse Events of Botulinum Toxin Type A in Facial Rejuvenation: A Systematic Review and Meta-Analysis","volume":"40","author":"Jia","year":"2016","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"NP327","DOI":"10.1093\/asj\/sjac036","article-title":"Complications of Cosmetic Botulinum Toxin A Injections to the Upper Face: A Systematic Review and Meta-Analysis","volume":"42","author":"Zargaran","year":"2022","journal-title":"Aesthetic Surg. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1007\/s00266-020-01983-w","article-title":"A Review of Complications Due to the Use of Botulinum Toxin A for Cosmetic Indications","volume":"45","author":"Sethi","year":"2021","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_16","first-page":"168","article-title":"Botulinum toxin injection for facial wrinkles","volume":"90","author":"Small","year":"2014","journal-title":"Am. Fam. Physician"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hong, S.O. (2023). Cosmetic Treatment Using Botulinum Toxin in the Oral and Maxillofacial Area: A Narrative Review of Esthetic Techniques. Toxins, 15.","DOI":"10.3390\/toxins15020082"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/8\/372\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:17:08Z","timestamp":1760033828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/8\/372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":17,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["toxins17080372"],"URL":"https:\/\/doi.org\/10.3390\/toxins17080372","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]}}}