BC04 Hyaluronic acid compound filling plus mesotherapy vs. botulinum toxin A for the treatment of horizontal neck lines: a multicentre, randomized, evaluator-blinded, prospective study

Abstract Although energy devices and botulinum toxin A (BTX-A) can alleviate age-related laxity, ptosis and platysmal bands, they have limited efficacy on horizontal neck lines. The purpose of this study was to investigate the efficacy, safety and patient satisfaction of a combined treatment of non-crosslinked hyaluronic acid (HA) compound filling plus mesotherapy for the correction of horizontal neck lines, in comparison with BTX-A. This multicentre, randomized, evaluator-blinded, prospective study enrolled female patients with moderate-to-severe horizontal neck lines corrected with either two or three sessions of non-crosslinked HA compound filling plus mesotherapy or one session of BTX-A injection. Improvement of the neck lines grades, Global Aesthetic Improvement Scale (GAIS), patient satisfaction and adverse events (AEs) were evaluated and compared at 1, 3, 6 and 10 months after the final treatment. Twenty-five patients received HA filling plus mesotherapy and 23 received BTX-A injection. Compared with BTX-A, the HA compound filling plus mesotherapy significantly improved the horizontal neck line grades on all follow-up visits (P < 0.001). Patients with different baseline grades (2, 2.5 and 3) demonstrated similar outcomes. The GAIS and patients’ satisfaction ratings were significantly higher for the HA filling plus mesotherapy treatment group (P < 0.001). Significantly higher pain ratings, higher incidence and longer recovery of adverse events (erythema, oedema and ecchymosis) were noticed in the combined treatment group (P < 0.001). No serious adverse events occurred. Compared with BTX-A, combined treatment with HA compound filling plus mesotherapy significantly improved moderate-to-severe horizontal neck lines and achieved a high level of patient satisfaction.