Botulinum Toxin and Social Perception: Effects of Upper-Face Treatment on Facial Emotion Attribution

Upper-face BoNT-A leads to a temporary, anatomically aligned, and emotion-specific attenuation of anger and surprise attribution while preserving pleasant and neutral emotional signaling. Importantly, no evidence of a global "frozen face" appearance emerged. These findings emphasize the importance of integrating facial emotional expression into pre-treatment assessment and using precise, region-specific neuromodulation to align aesthetic outcomes with individual patient intentions.