Patient satisfaction with different botulinum toxin type A formulations in the treatment of moderate to severe upper facial rhytids

Background: The clinical characteristics of botulinum toxin type A (BoNTA) depend on the formulation used. Objective: To evaluate whether switching BoNTA formulations affects patient satisfaction. Methods: Forty patients enrolled and all were satisfied or extremely satisfied with Allergan BoNTA (BoNTA-Allergan) treatment in the glabellar +/- crow's feet +/- forehead area(Ps) in the preceding 6 months. Once improvement from this previous treatment had started to diminish, treatment was replicated using Ipsen BoNTA (BoNTA-Ipsen) at a 1: 2.5 dose ratio. Results: The incidence of patients rating treatment as effective or very effective in making them look younger, look rested, and look less stressed was significantly higher with BoNTA-Allergan than BoNTA-Ipsen - 83% versus 36%, 90% versus 39%, and 83% versus 33%, respectively - even though evaluations were performed a mean of 20 weeks after BoNTA-Allergan treatment and only 16 weeks after BoNTA-Ipsen treatment. The incidence of patients who were satisfied or extremely satisfied was 100% (BoNTA-Allergan) versus 31% (BoNTA-Ipsen). BoNTA-Allergan was preferred by 69% of patients. Conclusions: Efficacy, satisfaction, and product preference ratings strongly favor the use of BoNTA-Allergan over BoNTA-Ipsen in the treatment of upper facial lines. Many patients who are satisfied with BoNTA-Allergan treatment become less satisfied if they are switched to BoNTA-Ipsen.