Objective Assessment of the Onset of RelabotulinumtoxinA in the Elevation of the Eyebrow and Its Clinical Implications

Background: The new ready-to-use botulinum toxins effectively treat lateral canthal lines; there is still little data on their efficacy in treating glabellar lines. The combined treatment of lateral canthal and glabellar lines allows the eyebrow to be repositioned. Aims: To show the onset and action of RelabotulinumtoxinA on the periocular area, by measuring the variations of the area under the eyebrow in a real-life setting. Patients/methods: In this real-life, multi-center case series, 36 patients (30 women, 6 men), aged 30-62 years, were treated with RelabotulinumtoxinA in glabellar and lateral canthal areas; patients were treated on day 0 (T0) and followed until day 30. Photos taken at T0 and at all follow-up time points were compared in calculating the median of the palpebral surface. Results: All patients responded to the treatment. Most of RelabotulinumtoxinA's effect on eyebrow position (76.25%) was seen within day 2, peaking in the first 24 h. The variation rate sharply declines by day 7. Patients showed a median increase in the exposed eyelid area of +11.91% compared to T0. Conclusions: In the real-world setting, RelabotulinumtoxinA showed efficacy in treating GLs and LCLs. In the post-intervention phases (follow-up and potential touch-ups), the fast onset of the ready-to-use product can save time. The palpebral area measurement technique, which was selected to assess objectively the response, may allow for a higher level of precision than measuring distances in the periocular range and can be helpful in this type of study.