Long-Term Consecutive OnabotulinumtoxinA Injections for Facial Aesthetic Treatment: A Real-World Study

Since the approval of OnabotulinumtoxinA, the introduction of new botulinum toxin formulations has raised concerns regarding the potential development of neutralizing antibodies, diminished efficacy, and reduced duration of effect. However, long-term data on the safety of repeated cosmetic OnabotA treatments remain limited, particularly in real-world clinical practice.

To evaluate the long-term use and patient perceived age after consecutive cosmetic OnabotA injections.

Single-center, single-injector, retrospective cohort study evaluating the long-term use of consecutive OnabotA injections and assessing patient perceived age.

Fifty patients (48 females, 2 males) were included, with a mean follow-up duration of 15.04 years (range: 8-26) and a total of 1,098 treatment cycles (8-67 cycles/patient). The cumulative OnabotA dose ranged from 332 to 3,684 units, with an average cumulative dose of 1,232 units/patient. When asked how old they perceived themselves compared to their current age, no patient reported feeling older than their chronologic age. Ninety-four percent stated appearing at least 2 years younger, while 76% perceived themselves to be between 5 and 12 years younger.

In this cohort of 50 patients treated over an average of 15 years, OnabotA demonstrated no evidence of treatment failure or diminished duration of aesthetic outcomes.