{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T09:55:24Z","timestamp":1773654924124,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Aesthetic patients in East Asia are commonly concerned about small apparent eye size. Simultaneous treatment of the glabellar and lateral canthal areas with botulinum neurotoxin has potential to provide improvements. This case series evaluated changes in eye size following treatment of these two areas using standard on-label doses of onabotulinumtoxinA in patients from Japan or China. Outcomes were assessed based on standardised frontal photographs taken before and after treatment (at rest, maximum smile, and maximum frowning). Changes in eye size were examined using a 4-point Likert scale, as evaluated by three independent groups: six injectors; six non-injecting observers; and treated patients. Furthermore, improvements in overall facial impression were analysed using two established tools: \u2018emotional attributes\u2019 and \u2018social attributes\u2019. Twenty East Asian subjects were included (n = 17 women; mean age: 37.5 \u00b1 6.4 years). The majority of evaluators in all three groups rated patients\u2019 eye size as \u2018significantly\u2019 or \u2018mildly\u2019 improved post-treatment, whether assessed at rest, when smiling, or during frowning. Furthermore, almost all evaluators noted improvements in one or more emotional and social attributes. This approach has significant potential as a culturally adapted aesthetic technique for improving eye size in East Asian patients. Larger multicentre studies are warranted.<\/jats:p>","DOI":"10.3390\/toxins18030145","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T08:41:26Z","timestamp":1773650486000},"page":"145","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Botulinum Toxin Treatment Can Enlarge Eye Appearance in Asian Patients and Improves Social and Emotional Attributes"],"prefix":"10.3390","volume":"18","author":[{"given":"Maur\u00edcio","family":"de Maio","sequence":"first","affiliation":[{"name":"MD Codes Institute, Sao Paulo 04528-133, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoko","family":"Kato","sequence":"additional","affiliation":[{"name":"Azabu Beauty Clinic Medical Corporation, Tokyo 106-0047, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Momoko","family":"Sato","sequence":"additional","affiliation":[{"name":"Injection Lab, Osaka 541-8513, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Akihabara Skin Clinic, Tokyo 101-0021, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Toyama","sequence":"additional","affiliation":[{"name":"Toyama Plastic & Cosmetic Surgery, Okinawa 900-0015, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Imaizumi","sequence":"additional","affiliation":[{"name":"Imaizumi Skin Clinic, Tokyo 106-0032, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Ishii","sequence":"additional","affiliation":[{"name":"Otsuka Cosmetic & Plastic Surgery, Tokyo 101-8535, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/j.1467-9280.2006.01750.x","article-title":"First impressions: Making up your mind after a 100-ms exposure to a face","volume":"17","author":"Willis","year":"2006","journal-title":"Psychol. 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