Use of Botulinum Toxin Before Surgical Lip Repositioning: A Randomized Clinical Trial

Area of Science:

• Dentistry
• Plastic Surgery
• Regenerative Medicine

Background:

• Excessive gingival display (EGD) is a common aesthetic concern.
• Surgical lip repositioning is a treatment option for EGD.
• The stability of surgical outcomes for EGD can be variable.

Purpose of the Study:

• To evaluate the efficacy of botulinum toxin type A (BT) in stabilizing surgical lip repositioning for EGD.
• To compare the outcomes of surgical lip repositioning with and without pre-surgical BT injections.

Main Methods:

• A randomized controlled parallel-group clinical trial was conducted.
• 18 participants with EGD were divided into two groups: test (BT + surgery) and control (surgery only).
• Botulinum toxin type A was injected 15 days prior to surgery in the test group. Gingival display and lip displacement were measured at 3 and 6 months postoperatively.

Main Results:

• Both groups showed statistically significant reductions in gingival display (GD) and upper lip displacement (LD) from baseline.
• After 6 months, the test group showed a greater reduction in GD (5.2 ± 1.1 mm) compared to the control group (3.2 ± 1.4 mm).
• Upper lip displacement was reduced by 45% in the test group versus 26% in the control group at 6 months.

Conclusions:

• Administering botulinum toxin type A 15 days before lip repositioning surgery enhances treatment stability.
• Pre-surgical BT injections significantly improve the reduction of excessive gingival display at 6 months.
• BT injection is an effective adjunct to surgical lip repositioning for managing EGD.