The treatment of moderate and severe glabellar lines by W-shaped excision of glabellar lines combined with botulinum toxin type A injection
10.3760/cma.j.cn114453-20250227-00040
- VernacularTitle:W形切除联合A型肉毒毒素注射治疗中、重度眉间纹
- Author:
Xue DONG
1
;
Shuai SHAO
1
;
Kejia ZHANG
1
Author Information
1. 吉林大学第一医院整形美容科，长春 130021
- Publication Type:Journal Article
- Keywords:
Botulinum toxins;
Glabellar lines;
W-shaped excision
- From:
Chinese Journal of Plastic Surgery
2025;41(10):1008-1015
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of W-shaped excision of glabellar lines combined with botulinum toxin type A (BTX-A) injection for treating moderate to severe glabellar lines.Methods:A retrospective analysis was conducted on the clinical data of patients at the Department of Plastic and Cosmetic Surgery, the First Hospital of Jilin University, from June 2021 to June 2024. All the patients had noticeable dynamic and static glabellar lines—primarily featuring vertical, depressed wrinkles. All of them underwent W-shaped glabellar excision combined with BTX-A injection. All the depressed wrinkles were completely removed during the operation, followed by suturing the bilateral tissues towards the center to improve the underlying tissue depression. Immediately following surgery, 20 units of BTX-A were administered into the glabellar muscle complex using the standardized five-point injection technique. Patients were instructed to receive repeat BTX-A injections at regular intervals of 4 to 6 months. Postoperative assessments were conducted at 6 and 12 months to evaluated both surgical efficacy and patient-reported satisfaction. Surgical outcomes were assessed by three independent physicians who evaluated the severity of glabellar lines at rest using a four-grade scale (none, mild, moderate, or severe). The consensus rating was determined by majority agreement. Patient satisfaction was assessed using a three-point Likert-type scale, categorized as very satisfied, satisfied, or dissatisfied.Results:The study cohort comprised 37 patients (12 males and 25 females), aged between 29 and 59 years (mean age, 42.4 years). All patients exhibited moderate to severe glabellar lines characterized by vertical depressed wrinkles. All incisions achieved primary healing without hematoma, infection, or other complications. During a follow-up period of 12 to 24 months, with an average of 13.7 months, all patients presented various degrees of improvement in glabellar lines. At 6 months postoperatively, 54.1% (20/37) of patients exhibited no visible lines, 40.5% (15/37) had mild static lines, and 5.4% (2/37) had moderate static lines; no cases of severe static lines were observed. The overall patient satisfaction rate (very satisfied and satisfied) was 94.6% (35/37). At 12 months postoperatively, 95.2% (20/21) of patients in the regular injection group (≥2 injections) maintained a status of no or mild static lines, whereas 43.8% (7/16) of patients in the single-injection group developed moderate to severe static lines. The patient satisfaction survey showed that the proportion of patients reporting "very satisfied" or "satisfied" was 100% (21/21) in the regular injection group and 87.5% (14/16) in the single-injection group. No serious complications were observed throughout the follow-up period.Conclusion:The combination of W-shaped excision and BTX-A injection provides satisfactory clinical result for moderate to severe glabellar lines. Patients who adhere to a regimen of regular injections demonstrate longer-lasting surgical effects.
