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Combination of W-plasty and Botulinum Neurotoxin Type A Injection for Preventing Rhytidectomy Scar in Asians

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  • Facial Surgery
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Abstract

Background

This study was conducted to see if better scar results could be obtained by administering botulinum neurotoxin type A (BoNTA) injection and W-plasty incision for preventing rhytidectomy scar.

Methods

All patients underwent extended deep-plane rhytidectomy in two groups. Group 1 had a straight incision line, and BoNTA was not given. Group 2 was injected with W-plasty and BoNTA. Photos were taken before surgery and twelve months after surgery. Two aesthetic surgeons analyzed the results using MSS, MSRS, and SBSES. Interrater reliability was measured using the intraclass correlation coefficient (ICC).

Results

Forty-nine patients were included in the study. Group 1 (Straight incision, No BoNTA) had 26, and Group 2 (W-plasty, BoNTA) had 23 patients. The interrater reliability in Group 1 was excellent for MSS (ICC, 0.957 [0.904–0.981]), and good in two of the interrater reliability measures (ICCs, 0.897 [0.769-0.954] for MSRS, and 0.821 [0.605–0.919] for SBSES). Interrater reliability in Group 2 was good in two out of three measures (ICCs, 0.760 [0.423–0.899] for MSS, 0.746 [0.392–0.893] for MSRS, and 0.851 [0.654–0.937] for SBSES). There was a significant statistical difference between Group 1 and Group 2, showing that Group 2 has superior outcomes (MSS, 6.596 ± 1.569 vs. 5.435 ± 0.590, P = 0.001; MSRS, 4.346 ± 0.967 vs. 3.652 ± 0.510, P = 0.003; SBSES, 3.788 ± 0.695 vs. 4.261 ± 0.541, P = 0.012).

Conclusions

Analyzed by three dedicated scar assessments, better results were obtained through combining W-plasty and BoNTA injections, so it is expected to be a useful method for improving scars.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266.

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Acknowledgements

The author is grateful to the reviewers of this article for recommendations that have improved it. Special thanks to my mentor, Dr. Jae-Hyun Park, my brother, Dr. Joel Kulesza, and my son, Mr. Joon Han, for their assistance in finalizing this work.

Funding

The author received no financial support for the research, authorship, and publication of this article.

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Authors and Affiliations

  1. Decade renewal aesthetic surgery clinic, 5-12 Cheongdam-dong, Gangnam-gu, Seoul, South Korea

    Chung-hee Han

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  1. Chung-hee Han
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Correspondence to Chung-hee Han.

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Han, Ch. Combination of W-plasty and Botulinum Neurotoxin Type A Injection for Preventing Rhytidectomy Scar in Asians. Aesth Plast Surg 47, 181–188 (2023). https://doi.org/10.1007/s00266-022-02970-z

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