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Use of Botulinum Toxin A in Direct Eyebrow Lift Scar

Phase 2
Recruiting
Conditions
Skin Scarring
Eyebrow Ptosis
Interventions
Registration Number
NCT06465056
Lead Sponsor
University of Sao Paulo
Brief Summary

Prospective, controlled and randomized study in which participants indicated for surgery to direct eyebrow lift will be randomized into two groups. In addition to surgery, the patients will be treated with botulinum toxin in one eyebrow and saline (placebo) in the other site. The patients participate as treatment and placebo at the same time. Assessments will be carried out through non-invasive exams.

Detailed Description

A component of eyebrow ptosis, part of the natural aging process, with or without asymmetries, is found in the majority of patients who seek the blepharoplasty procedure.

There are several procedures to address this condition, but none of them is undoubtedly superior to the others. The direct eyebrow lift technique is known for providing good eyebrow suspension, predictable results and relatively low complexity surgery, which can be performed with local anesthesia.

However, the biggest concern for surgeons and patients is the final appearance of the scar, which will be in a visible area of the face. Botulinum toxin A has been used in recent studies precisely to improve the appearance of scars. Previous studies mainly evaluated traumatic lacerations and post-tumor excision reconstructions, obtaining positive results, with an improvement in the appearance of the wounds in patients who used the medication. It is a safe drug, used for several years for other purposes and without serious adverse effects according to these studies.

The objective of this study is to compare the use of botulinum toxin A versus 0.9% saline solution in the healing of direct eyebrow lift surgery.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patients over 18 years of age with indication for direct eyebrow lift surgery.
Exclusion Criteria
  • Vulnerable groups: children, pregnant women and immunosuppressed patients
  • Allergy to botulinum toxin A
  • Patients under 18 years old
  • Women who are breastfeeding
  • Patients with muscular/neuromuscular diseases such as myasthenia gravis and amyotrophic lateral sclerosis
  • Patients who underwent botulinum toxin A injection in the last 6 months prior to surgery
  • Patients with a history of radiotherapy, chemotherapy or hematological disorders
  • Refusal to participate in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Right side treatmentBotulinum toxin type APatients receive botulinum toxin A in right side eyebrow scar and saline in left side scar.
Left side treatmentBotulinum toxin type APatients receive botulinum toxin A in left side eyebrow scar and saline in right side scar.
Primary Outcome Measures
NameTimeMethod
Scar evaluation 1One month, three months and six months after surgery

Eyebrow direct lift scar evaluation, comparing botulinum toxin A side with saline side, using the following assessment scale: Visual Analogue Scale Score (VAS). The VAS is described as a quick and practical way of evaluating the patient's experience in relation to pain, on a scale of 0 to 100 millimeters, ranging from no pain to the worst pain imaginable.17 Due to the ease and simplicity of its application, it is used in several studies to evaluate various parameters, even if not consistent with their original validation. Here it will be using meaning 0 (no scar) and 100 milimeters (worst scar imaginable).

Scar evaluation 2One month, three months and six months after surgery

Eyebrow direct lift scar evaluation, comparing botulinum toxin A side with saline side, using the following assessment scale: Vancouver Scar Scale (VSS). The VSS ranges from 0 (best) to 13 (worst) points, evaluating vascular distribution, thickness, flexibility and pigmentation.

Scar evaluation 4One month, three months and six months after surgery

Eyebrow direct lift scar evaluation, comparing botulinum toxin A side with saline side, using the following assessment scale: Patient and Observer Scar Assessment Scale (POSAS).

POSAS was developed in 2004 and is the first scale to consider the perspective of the patient and the evaluator. It is useful in evaluating postoperative and linear scars, ranging from 5 (worst) to 50 (best). It encompasses physical properties of scars such as vascularity, pigmentation, thickness, relief and flexibility, in addition to two patient symptoms, pain and itching.

Scar evaluation 3One month, three months and six months after surgery

Eyebrow direct lift scar evaluation, comparing botulinum toxin A side with saline side, using the following assessment scale: Stony Brook Scar Evaluation Scales (SBSESs). The SBSES was developed for short-term assessment of repaired burns, and is described as useful for assessment of suture scars. It consists of five indicators: length, elevation or depression, color, suture or staple marks and general appearance. Your score ranges from 0 (worst) to 5 (best)

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

University of São Paulo (Clinical Hospital)

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São Paulo, Brazil

Ophthalmology Dept. University of Sao Paulo General Hospital

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Sao Paulo, Brazil

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