Background: Full-face aesthetic treatment with neuromodulators is common in routine practice but not widely analyzed in clinical studies.
Methods: This was a retrospective, two-center chart review evaluating the effectiveness and safety of full-face onabotulinumtoxinA injections for the aesthetic treatment of adult females, all of whom had severe forehead lines at baseline. Patients received a total dose of 114 U: 64 U in the upper face using the on-label treatment pattern for glabellar, crow's feet, and forehead lines; 20 U per side in the jawline based on the recently proposed "toxin lift" method; and 10 U in the chin.
Results: Thirty-three females were included (mean age: 42.5 ± 7.6 years). Physician-rated forehead line severity improved from "severe" to "mild" or "none" in all patients at 4 weeks, as assessed using the Facial Wrinkle Scale and Forehead Lines Grading Scale. All study participants showed greater facial symmetry, enhanced jawline contour, and high patient satisfaction (FACE-Q Satisfaction with Outcome, 83.9 ± 9.0; Satisfaction with Forehead and Eyebrows, 95.4 ± 5.7). Adverse events were minor and transient.
Conclusions: Full-face onabotulinumtoxinA was effective in reducing facial lines and improving overall symmetry and jawline contour, with high levels of patient satisfaction, and a favorable safety profile.
Level of evidence: Level III.
Keywords: Botulinum toxin; Full-face treatment; Neuromodulator; Onabotulinumtoxina; Toxin lift; Upper facial lines.
© 2025 The Authors.