Using botulinum toxin type A injections for cosmetic purposes has become commonplace over the past couple of decades. According to the author of a new study from Italy, however, objectively measuring the procedure’s effectiveness poses something of a challenge.
Study author Maurizio Cavallini, M.D., a plastic surgeon in Milan, Italy, acknowledges that methods employed to evaluate the treatment’s efficacy are validated and reliable, but notes that they are usually based on subjective factors. He says an objective, quantitative scale is still needed.
Dr. Cavallini proposes an objective, fast and reproducible method to evaluate the severity of wrinkles with a three-dimensional imaging and texture analysis. In his study he used Digital Analysis of the Cutaneous Surface (DACS) to analyze cutaneous texture. Measures were taken in the glabellar area before and one month after injecting 15 units of Botox into each of eight female patients.
DACS was able to detect improvement in all cases. On average, static lines decreased by 12.4% and dynamic lines by 41.2%.
“The goal of the study was to offer a precise and objective evaluation of the improvement of the glabellar lines — and of the texture of the skin — with botulinum toxin type A using a particular three-dimensional camera able to give the percentage of improvement both with a color, 3-D picture and with numerical graphics,” Dr. Cavallini tells Cosmetic Surgery Times. “This is very important in order to overcome the subjective scientific evaluation — which until now used a facial scale that is subject to the different sensitivities of physicians — and to offer a precise study of the onset of the toxin and its efficacy and duration.”
Dr. Cavallini says the results of the study will help surgeons better evaluate post-treatment asymmetry and/or the need to improve clinical results.
“From the patient’s point of view,” he adds, “this study offers the possibility of having a direct comparison between the pre- and post-treatment.”