This was an interesting study. Lower eyelid surgery (blepharoplasty where you remove skin) leaves a thin scar just under the eyelash line. Yes, this scar is visible, but almost always fades well. This study was out of Taiwan, and the issue is that Asian skin can form more visible scars- they can elevate, pigment, etc- more than Caucasian skin. So this study was a randomized, double blinded study to look at if Botox injections around the time of lower eyelid surgery improved scarring.
“Botulinum Toxin to Improve Lower Blepharoplasty Scar: A Double Blinded Randomized Vehicle Controlled Clinical Trial,” in the September 2021 Aesthetic Surgery Journal. They discuss how Botox is used to alleviate facial wrinkling by blocking muscles and can improve scar quality by reducing scar tension.
Method:
40 patients were randomized to receive Botox or saline injections into the lateral orbicularis oculi muscle immediately after wound closure during blepharoplasty surgery. A Scar Scale (pigmentation, scar height, pliability, vascularity) and photos with width measurements at 3 reference points were recorded.
Findings?
37 patients completed the trial. Scar widths in the experimental group at all measured oints were significantly narrower than control. There was no difference in the Scar Scale results.
My thoughts?
Interesting. I have always been super hesitant to inject Botox into fresh post op patients, as I am afraid the Botox could migrate to other areas, as the surgery opens up communications between areas that usually don’t exist. They did 6-12 units on each side, in 3 injection sites. The photos look good. They don’t talk about any issues with immediate injection of Botox.
I do a deep tightening stitch on my patients during lower eyelid surgery. It can given them a pinched look, until that deep suture dissolves, but it is taking tension off of the scar which is likely giving better longterm scar results. So I wonder if Botox would offer any other added benefit.
Again, interesting. Just add another thing to the Botox list.