The Efficacy and Safety of Botulinum Toxin Type A in Prevention of Hypertrophic Scars After Epicanthoplasty: A Split-Face Double-Blinded Randomized Controlled Trial.

[BACKGROUND] Timely intervention can improve the aesthetic outcome of surgical scars, and botulinum toxin type A (BTXA) has demonstrated its potential as an effective treatment. However, conclusive scientific evidence is needed to definitively confirm the specific efficacy of BTXA following epicanthoplasty.

[METHODS] A total of 21 patients who underwent epicanthoplasty were enrolled. Either BTXA or normal saline was randomly injected into the left or right epicanthus immediately after epicanthoplasty. The efficacy of scar prevention was assessed at a 1-month and 6-month follow-up visit using various assessment scales, and scar widths were also measured. The safety assessment included evaluating the complications and adverse effects after injections.

[RESULTS] Totally, 20 patients completed the entire follow-up period. At 6-month follow-up, significant improvements were noted (P<0.05) in the treatment group compared to the control group across all evaluated metrics: the Modified Stony Brook Scar Evaluation Scale (total scores: 6.73±1.26 vs 5.75±1.60), Observer Scar Assessment Scale (total scores: 6.35±5.93 vs 8.55±5.65), Patient Scar Assessment Scale (color scores: 1.10±1.17 vs 1.85±1.69), Visual Analog Scale (total scores: 8.48±1.24 vs 7.94±1.37), and the average scar widths (0.37±0.18mm vs 0.68±0.42mm). No adverse effects were observed.

[CONCLUSIONS] BTXA can effectively prevent scar hyperplasia after epicanthoplasty, especially in improving scar pigmentation, width, and softness.

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