Improving the Appearance of Surgical Facial Scars With IncobotulinumtoxinA and Microneedling

June 2020 | Volume 19 | Issue 6 | Original Article | 611 | Copyright © June 2020

Published online May 8, 2020

Gabriela R. Casabona , Thais Bello Giacomo

Ocean Clinic, Marbella, Spain

croneedling was repeated after 15 days. The 2015 subjects were also instructed to wear sunscreen after suture removal.

Treatment Evaluation
The modified Vancouver Scar Scale4 (VSS) was used to evaluate treatment response. For each subject, scar scores could range from 0 (normal) to 14 (purple, hyperpigmented, adherent, >6 mm; Table 1). VSS scores in both groups were assessed on day 7 and day 30 after suture removal by the Mohs surgeon and an independent dermatologist. A Patient Satisfaction Scale was used to assess overall satisfaction with treatment outcomes on a scale of 1 (Very Unsatisfied) to 5 (Very Satisfied) on day 30.

Statistical Analysis
Pearson's chi-square test or Fisher's exact test was used to compare the categorical variables between the groups in the presence of expected values less than 5. To compare numerical variables between the groups, the Mann-Whitney test was used due to the absence of normal data distribution. The Wilcoxon test was used for related samples to compare the scores between the two evaluations in each group. To compare the numerical variables between groups and evaluations simultaneously, ANOVA for repeated measurements was used followed by the Tukey post hoc test for between-group comparisons, and the contrast profile test for comparison between the variables transformed into ranks due to the absence of normal distribution. For each test, P<0.05 was considered significant. Calculations were made with the SAS System for Windows, v. 9.2 (SAS Institute Inc., Cary, NC).


Each group included 35 subjects, all of whom complied with all study requirements and were evaluated on their scheduled days. On day 7 after treatment, mean (SD) VSS scores were 10.4 (1.14) among treated subjects vs 9.5 (1.88) among control subjects (P<0.05); however, on day 30, mean VSS scores had decreased to 1.1 (0.89) for treated subjects vs 7.6 (1.72) for control subjects (P<0.05). Changes in individual VSS variables are shown in Figure 1. The Patient Satisfaction Score was significantly higher among treated patients vs. control subjects (4.45 vs 3.14; P<0.001; Figure 2). Images of subjects immediately after surgery and 30 days post-treatment are shown in Figures 3 to 6.