A Meta-Analysis of the Efficacy and Safety of Botulinum Toxin Type A for the Management of Scars After Facial Surgery.

[BACKGROUND] Postoperative scarring of the face can cause a serious psychological burden on people. Botulinum toxin type A has shown potential effectiveness in preventing scarring after facial surgery. The study aims to evaluate the role of botulinum toxin type A in postoperative scar management.

[METHODS] We searched PubMed, Embase, MEDLINE, the Cochrane Library (CENTRAL), and Web of Science for all randomized controlled trials (RCTs) on the use of botulinum toxin type A in the treatment of postoperative facial scars, including all English articles published up to April 15, 2024.

[RESULTS] Twelve randomized controlled trials involving 351 patients undergoing facial surgery were included. Quantitative analysis, STATA 17.0 software was used for meta-analysis, and fixed-effect and random-effects models were selected according to the size of heterogeneity, and the results were expressed as SMD and 95% CI for continuous data and OR and 95% CI for dichotomous data. Subgroup analyses were performed according to the different control groups. The OR and 95% CI of adverse effects were 1.74 (0.41-7.43). The p value of adverse reactions and PSAS results was greater than 0.05.

[CONCLUSION] Due to the small heterogeneity of scar width, OSAS, and PSAS, SMD and 95% CI were -1.00 (-1.20 to 0.80), -0.61 (-1.0 to 0.13), and -0.08 (-0.56 to 0.39), respectively, using a fixed-effect model. Due to large heterogeneity, VAS and VSS scores were scored using a random-effects model, with SMDs and 95% CIs of 1.00 (0.47-1.53) and -0.41 (-0.73 to 0.1), respectively.

[TRIAL REGISTRATION] PROSPERO number: CRD42024538070.