Are Post-Care Recommendations Following Upper-Face Botulinum Toxin Treatment Scientifically Necessary? A Retrospective Study Based on 5000 Patients.

Abstract

Background: Patient care following botulinum toxin injections has long been guided by anecdotal instructions, often based on theoretical considerations. This study evaluates the necessity of extended post-treatment instructions by analyzing outcomes and satisfaction in patients who followed only a 10 min precaution protocol.

Materials and methods: A retrospective, multicentric study was conducted across six Italian centers, analyzing 5014 patients treated with botulinum toxin for upper facial wrinkles between 2015 and 2020. Outcomes included adverse effects-particularly upper eyelid ptosis-and patient satisfaction. Follow-up was performed at two weeks.

Results: No cases of upper eyelid ptosis were observed. Among 4000 patients who attended follow-up, adverse effects occurred in only 5.99%, notably lower than rates reported in the literature. Of the 2010 patients who completed the satisfaction questionnaire, 90% reported being very satisfied. These findings support the safety of limiting post-treatment instructions to 10 min.

Conclusions: Our findings indicate that omitting extended post-injection instructions does not negatively impact patient satisfaction or complication rates. Given the toxin's rapid internalization and localized effect, extended behavioral restrictions may be redundant. However, the absence of a control group and lack of statistical analyses limit the strength of these conclusions. In addition, this is a short-term study. Future prospective, randomized trials are needed to develop evidence-based post-care protocols to optimize esthetic outcomes, patient safety, and long-term efficacy.