GLASS LAB · Medical Aesthetics Evidence Index 303 cells · 19,226 papers · 5,969 top-tier evidence

Wrinkle / Line · Perioral vertical lines

Botulinum toxin a evidence for Perioral vertical lines

C 46.8 / 100 Supported 1 RCT/meta · 1 clinical/observational · 0 case · 11 total
Early-stage evidence

This is an early evidence stage based mainly on observational studies and case reports. Use it as supplementary reference, and follow your doctor's judgment for treatment decisions.

Grade combines the quantity and quality of the research, while direction is a separate signal showing how the papers assess effectiveness.

Includes meta-analysis/SR Median year 2016 Last 5 years 46% Positive results 27% Korea/Asia 2

Known in Korea as

톡신보톡스제오민디스포트코어톡스주름 보톡스다한증 보톡스디자인 보톡스사각턱 보톡스얼굴전체 톡신

Procedure and brand names vary, but the evidence above applies to the same procedure mechanism.

Key papers

tier1 Use of AbobotulinumtoxinA for Cosmetic Treatments in the Neck, and Middle and Lower Areas of the Face: A Systematic Review. Toxins · 2021 · PMID 33671800

Abstract summary (English) AbobotulinumtoxinA (aboBoNT-A) has been used for various cosmetic purposes, including minimization of moderate to severe lines, or other cosmetic indications, in the face and neck. We carried out a systematic review to identify all relevant evidence on the treatment approaches and outcomes of aboBoNT-A as a cosmetic treatment of the middle and lower areas of the face, and the neck. Embase, MEDLINE, Cochrane Library,...

Journal Article, Research Support, Non-U.S. Gov't, Systematic Review

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tier2 Comparison of different consensuses of BTXA in different countries. Journal of cosmetic dermatology · 2016 · PMID 27699964

Abstract summary (English) The most international dosing guidelines on the use of botulinum toxin type A (BTXA) drugs support a 1:1 dose relationship between OnaBTXA and IncoBTXA and 1:2.5 between OnaBTXA and AboBTXA. However, different facial zones demonstrate different doses conversion ratios. The comparative analysis of nine consensuses on the use of Abo-, Ona-, and IncoBTXA in the United States, Russia, and Europe has been performed.

Comparative Study, Journal Article, Review

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tier0_review Anatomical-based diagnosis and filler injection techniques: marionette line (static labiomandibular fold). The Journal of dermatological treatment · 2025 · PMID 39894451

Abstract summary (English) PURPOSE: Marionette lines, also known as static labiomandibular folds, are common age-related perioral wrinkles that impact facial aesthetics, particularly in Asian populations. This article aims to examine the anatomical basis, etiology, and filler injection techniques used for treating marionette lines. MATERIALS AND METHODS: The study reviews anatomical studies and clinical practices related to marionette lines.

Journal Article, Review

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tier0_review Cosmetic Treatment Using Botulinum Toxin in the Oral and Maxillofacial Area: A Narrative Review of Esthetic Techniques. Toxins · 2023 · PMID 36828397

Abstract summary (English) Botulinum toxin (BoNT) is an anaerobic rod-shaped-neurotoxin produced by Clostridium botulinum, that has both therapeutic and lethal applications. BoNT injection is the most popular cosmetic procedure worldwide with various applications. Patients with dynamic wrinkles in areas such as the glabella, forehead, peri-orbital lines, nasal rhytides, and perioral rhytides are indicated.

Journal Article, Review, Research Support, Non-U.S. Gov't

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tier0_review Role of botulinum toxin A in improving facial erythema and skin quality. Archives of dermatological research · 2021 · PMID 34519860

Abstract summary (English) Botulinum toxin A (BTX-A) injections have become the most popular noninvasive cosmetic procedures performed worldwide. With growing interest, investigators continue to uncover an expanding array of aesthetic indications for BTX-A. Botulinum toxin A has been used off-label in the management of masseter hypertrophy for facial slimming, platysmal bands, nasal 'bunny' lines, perioral rhytides, gummy smile and scars, to...

Journal Article, Review

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tier0_review Guidelines on the use of botulinum toxin type A. Indian journal of dermatology, venereology and leprology · 2008 · PMID 18688099

Abstract summary (English) UNLABELLED: Botulinum toxin is available as types A and B. These two different forms need different dosages and hence, the physician needs to be familiar with the formulations. A thorough knowledge of the anatomy and physiology of the muscles in the area to be injected is essential.

Journal Article, Practice Guideline

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tier_other International Consensus Recommendations on the Aesthetic Usage of Ready-to-Use AbobotulinumtoxinA (Alluzience). Aesthetic surgery journal · 2024 · PMID 37490767

Abstract summary (English) Alluzience (abobotulinumtoxinA RTU; Ipsen, Paris, France and Galderma SA, Lausanne, Switzerland) is the first ready-to-use (RTU) botulinum toxin type A liquid solution approved for the treatment of glabellar lines in Europe. In this article, the authors provide consensus recommendations on the aesthetic usage of abobotulinumtoxinA RTU. Members of the International Board on Alluzience convened to develop consensus on...

Journal Article, Research Support, Non-U.S. Gov't, Consensus Statement

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tier_other IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations. Clinical, cosmetic and investigational dermatology · 2015 · PMID 26089695

Abstract summary (English) BACKGROUND: Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A) in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy...

Journal Article

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tier_other International consensus recommendations on the aesthetic usage of botulinum toxin type A (Speywood Unit)--Part II: Wrinkles on the middle and lower face, neck and chest. Journal of the European Academy of Dermatology and Venereology : JEADV · 2010 · PMID 20569284

Abstract summary (English) BACKGROUND: Azzalure® (Galderma SA), a newly approved European botulinum neurotoxin type A (BoNT-A), is derived from Dysport™ (Ipsen Ltd.), which has a 20-year history of product consistency and has been widely used for various aesthetic and therapeutic applications. Azzalure® and Dysport™ are collectively referred to as BoNT-A (Speywood Unit) after the unit of their activity, and are distinct from other commercial...

Consensus Statement, Journal Article

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tier_other Botulinum toxin A treatment of perioral rhytides. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] · 2003 · PMID 12752516

Abstract summary (English) BACKGROUND: Botulinum toxin A is well documented as a useful therapy for smoothing dynamic facial rhytides of the upper face. Most controlled studies have focused on the treatment of glabellar frown lines, horizontal forehead lines, and crow's feet. Reports of botulinum toxin A use in the lower face are few and anecdotal.

Journal Article

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Suggested interpretation

Limited evidence

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