Botulinum Neurotoxins Type A &B: A Comparative Cross-Sectional Study of Mechanism, Efficacy, and Clinical Applications

Botulinum Neurotoxins Type A &B: A Comparative Cross-Sectional Study of Mechanism, Efficacy, and Clinical Applications | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Botulinum Neurotoxins Type A &B: A Comparative Cross-Sectional Study of Mechanism, Efficacy, and Clinical Applications Sedra Alibrahim, Belal Almeshaal, Asia Sawwan, haidar yousef This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8817828/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Botulinum toxin type A and type B are widely used in cosmetic and medical practice due to their neuromuscular blocking properties. Although both toxins share a similar mechanism of action, differences in pharmacological characteristics have raised questions regarding their comparative efficacy, safety, and clinical applications. Direct comparative data across multiple outcome measures remain limited. Objective This study aimed to compare the clinical efficacy and safety of botulinum toxin type A and type B in cosmetic and medical indications, and to assess whether statistically significant differences exist between the two types with respect to adverse effects, severity of improvement, patient satisfaction, duration of effect, time to onset, and type of diagnosis. Methods A comparative cross-sectional study was conducted involving 126 patients who received either botulinum toxin type A or type B injections for cosmetic or medical purposes. Data were collected using a structured electronic questionnaire and included demographic variables, clinical outcomes, adverse effects, satisfaction levels, duration and onset of effect, and indication type. Statistical analysis was performed using descriptive statistics, chi-square tests, and Fisher’s exact tests where appropriate. Statistical significance was set at P < 0.05. Results No statistically significant differences were observed between botulinum toxin type A and type B in terms of incidence or severity of adverse effects, degree of clinical improvement, overall patient satisfaction, duration of effect, time to onset, or diagnostic use (cosmetic versus medical). Both toxin types demonstrated comparable efficacy and safety profiles across all evaluated parameters. Conclusion Botulinum toxin type A and type B exhibit a high degree of clinical equivalence in terms of efficacy, safety, and patient-reported outcomes in both cosmetic and medical applications. The choice between the two toxins should therefore be guided by clinical context, practitioner experience, availability, and individual patient factors rather than expectations of substantial differences in therapeutic performance. Botulinum Toxin Type A Botulinum Toxin Type B Cosmetic Application Clinical efficacy Adverse Effects Introduction Botulinum neurotoxins (BoNTs) are among the most potent biological substances known and have become widely established as essential therapeutic and cosmetic agents in modern clinical practice. Derived from Clostridium botulinum, these neurotoxins exert their effect by inhibiting acetylcholine release at the neuromuscular junction, leading to temporary, reversible muscle relaxation. Among the seven identified serotypes (A–G), botulinum toxin type A (BoNT-A) and type B (BoNT-B) are the most extensively studied and clinically utilized. (1) BoNT-A is the most commonly used serotype worldwide, particularly in cosmetic dermatology for the treatment of facial wrinkles and fine lines, as well as in various medical conditions such as muscle spasticity, dystonia, chronic migraine, and hyperhidrosis. BoNT-B, although less frequently used, represents an important alternative, especially in patients who develop resistance or reduced responsiveness to BoNT-A, potentially due to neutralizing antibody formation. (2) Despite sharing a similar mechanism of action, BoNT-A and BoNT-B differ in their molecular structure, receptor binding profiles, pharmacodynamic properties, onset of action, duration of effect, and side-effect profiles. Several studies have suggested subtle differences between the two types, such as a faster onset but shorter duration of effect with BoNT-B, and a potentially higher incidence of autonomic side effects (e.g., dry mouth) in certain indications. However, the clinical relevance of these differences remains controversial, and published results are often inconsistent (3). Moreover, while numerous studies have evaluated the efficacy and safety of each toxin individually, direct comparative studies assessing both types across a broad range of clinical and cosmetic outcomes remain limited, particularly in real-world clinical settings and in populations from the Middle East. This lack of comprehensive comparative data creates uncertainty in clinical decision-making regarding optimal toxin selection based on efficacy, safety, patient satisfaction, and indication type. (4) Therefore, a comparative evaluation of BoNT-A and BoNT-B across multiple clinically relevant parameters—including adverse effects, severity of improvement, patient satisfaction, duration of effect, onset time, and diagnostic use—is essential to better inform evidence-based practice and optimize patient outcomes.(5) Objective This study aims to evaluate and compare the clinical efficacy and safety of botulinum toxin type A and type B across a range of cosmetic and medical indications. The primary variables assessed include the incidence of adverse effects, severity of adverse effects, overall patient satisfaction, duration of effect, degree of clinical improvement after treatment, time to onset of effect, and type of indication (cosmetic versus medical). The study further seeks to determine whether statistically significant differences exist between the two toxin types with respect to these variables, to analyze factors influencing clinical outcomes in order to provide scientific evidence that supports selecting the most appropriate toxin for each patient, and to offer data-driven recommendations regarding the optimal use of both toxin types in cosmetic and medical applications. Significance The significance of this study lies in the following aspects: Enhancing clinical knowledge: Despite the widespread use of both toxin types, recent literature indicates knowledge gaps regarding precise comparisons between type A and type B across various clinical parameters, such as degree of improvement and duration of effect. Supporting clinical decision-making: The study findings may assist physicians and practitioners in selecting the most suitable toxin based on patient expectations, type of diagnosis, and responsiveness of the target muscles. Improving patient satisfaction: Identifying factors that influence satisfaction and duration of effect contributes to optimizing the clinical experience and reducing risks associated with repeated injections or suboptimal dosing. Contributing to global literature: This study provides additional data that can be compared with international studies, particularly in populations or settings where extensive comparisons between the two toxin types have not been conducted. Evaluating medical versus cosmetic use: Understanding the relationship between toxin type and indication allows for improved treatment planning and prioritization of efficacy versus safety for each application. Inclusion and Exclusion Criteria Inclusion Criteria Patients who received botulinum toxin type A or type B injections during the study period, Cosmetic cases, including facial and forehead wrinkles, or medical indications such as hyperhidrosis, muscle spasticity, or migraine, Availability of adequate clinical follow-up to assess all study variables (adverse effects, degree of improvement, duration of effect), Complete medical records allowing accurate classification of variables. Exclusion Criteria Patients who received other botulinum toxin types (other than A or B), Uncertain cases or records with incomplete or inaccurate data (“not sure” or “both”), Patients with complex neuromuscular disorders that hinder accurate assessment of improvement, Patients with known hypersensitivity to botulinum toxins or previous allergic reactions preventing fair clinical comparison, Cases in which follow-up was insufficient to fully assess the duration of effect within the defined evaluation period. Methods Study Design A comparative cross-sectional study design was employed. Patients were selected according to predefined inclusion and exclusion criteria to ensure the accuracy and reliability of the results. Data Collection Data were collected using an electronic questionnaire distributed to patients attending clinics and cosmetic centers in Damascus Governorate. Collected variables included demographic characteristics (age, sex, occupation), incidence of adverse effects, degree of improvement, satisfaction level, duration of effect, time to onset of effect, and type of indication (cosmetic versus medical). All data were carefully documented to minimize classification errors or duplication. Statistical Analysis Descriptive tables were used to present the distribution of variables. Differences between toxin types were analyzed using the chi-square test for multi-category tables and Fisher’s exact test for small sample sizes or when expected cell counts were less than five, Uncertain data were excluded to ensure scientific accuracy, Statistical analysis was performed using SPSS software, version 26, Statistical significance was set at p < 0.05. Discussion of Results Age Group Study data show that the majority of participants were aged 35–50 years (53.97%), followed by the 18–25-year age group (36.51%). This age distribution is consistent with the nature of cosmetic botulinum toxin treatment, as concern for aesthetic appearance increases with age and the onset of early signs of aging. These findings align with previous studies indicating that individuals aged 30–50 years constitute the largest group seeking cosmetic botulinum toxin treatments, with lower demand among younger and older age groups (as shown in Table 1 ). Table 1. Statistical Results Patient Age Group Age Group Number Percentage (%) < 18 years 4 3.17 18–25 years 46 36.51 35–50 years 68 53.97 ≥ 50 years 8 6.35 Total 126 100.0 Patient Sex Sex Number Percentage (%) Female 123 97.62 Male 3 2.38 Total 126 100.0 Marital Status Marital Status Number Percentage (%) Single 43 34.13 Married 75 59.52 Widowed 7 5.56 Engaged 4 3.17 Total 126 100.0 Educational Level Educational Level Number Percentage (%) University degree 93 73.81 Postgraduate degree 18 14.29 Secondary school (High school) 12 9.52 Less than secondary 3 2.38 Total 126 100.0 Employment Status Occupation Number Percentage (%) Homemaker 53 42.06 Self-employed 35 27.78 Student 13 10.32 Government employee 19 15.08 Unemployed 5 3.97 Retired 1 0.79 Total 126 100.0 Diagnosis / Purpose of Treatment Treatment Indication Number Percentage (%) Cosmetic use only 108 85.71 Hyperhidrosis 23 18.25 Migraine 20 15.87 Spastic muscle pain 8 6.35 Lip fissures 1 0.79 Gummy smile 1 0.79 Type of Botulinum Toxin Used Toxin Type Number Percentage (%) Not sure 59 46.83 Type B 31 24.60 Type A 18 14.29 Both at different times 18 14.29 Total 126 100.0 Duration of the Condition Duration Number Percentage (%) 7 years 25 19.84 Total 126 100.0 Severity of Symptoms Before Treatment Severity Number Percentage (%) Mild 41 32.54 Moderate 57 45.24 Severe 22 17.46 Interfering with daily life 6 4.76 Total 126 100.0 Time to Onset of Treatment Effect Time to Effect Number Percentage (%) 3 days – 1 week 42 33.33 1–2 weeks 38 30.16 Day 2–3 28 22.22 After 2 weeks 7 5.56 From day one 4 3.17 No improvement noticed 4 3.17 Other / unspecified 3 2.38 Total 126 100.0 Degree of Improvement After Treatment Improvement Score Number Percentage (%) 5 (Marked improvement) 59 46.83 4 14 11.11 3 (Moderate improvement) 41 32.54 2 5 3.97 1 (No improvement) 7 5.56 Total 126 100.0 Occurrence of Adverse Effects Response Number Percentage (%) Yes 40 31.75 No 78 61.90 Maybe 8 6.35 Total 126 100.0 Type of Adverse Effects Adverse Effect Frequency Percentage (%) Headache 20 50.00 Injection site pain/swelling 13 32.50 Eyelid ptosis 10 25.00 Unintended muscle weakness 9 22.50 Undesirable cosmetic outcome 6 15.00 Dry mouth 3 7.50 Dysphagia 2 5.00 Allergic reaction 2 5.00 Other 2 5.00 Overall Satisfaction With Treatment Satisfaction Level Number Percentage (%) Very satisfied 74 58.73 Slightly satisfied 39 30.95 Neutral 7 5.56 Not satisfied 6 4.76 Total 126 100.0 Intention to Continue Treatment Response Number Percentage (%) Yes 106 84.13 Maybe 15 11.90 No 5 3.97 Total 126 100.0 Site of Hyperhidrosis Site Number Percentage (%) Axilla 18 78.26 Soles of feet 2 8.69 Not specified 3 13.04 Number of Treatment Sessions Number of Sessions Number Percentage (%) One session 20 15.87 2–3 sessions 56 44.44 4–6 sessions 36 28.57 7–10 sessions 8 6.35 >10 sessions 6 4.76 Total 126 100.0 Duration of Injection Effect Duration Number Percentage (%) 6 months 41 32.54 Not specified 3 2.38 Total 126 100.0 Statistical Analysis of the Relationship Between Botulinum Toxin Type and Clinical Outcomes Sex The results demonstrated a marked predominance of female participants (97.62%) compared with males (2.38%). This trend reflects prevailing social and cultural norms, whereby cosmetic care is more common among women. These findings are consistent with existing literature indicating that females represent the majority of botulinum toxin users in most global studies (as shown in Table 1 ). Marital Status Data indicate that most participants were married (59.52%), while approximately one-third were single (34.13%). The higher proportion of married individuals may be related to greater financial and social stability, enabling them to afford cosmetic procedures. Other studies have similarly observed that married individuals tend to invest more in personal appearance than single individuals (as shown in Table 1 ). Educational Level The study revealed that 73.81% of participants had a university-level education, and 14.29% held postgraduate degrees. This suggests that the primary users of botulinum toxin treatments are individuals with higher educational attainment, which may be associated with greater health and aesthetic awareness as well as the economic capacity to cover treatment costs. This observation is consistent with studies linking educational level to interest in cosmetic treatments and awareness of their risks and benefits (as shown in Table 1 ). Employment Status Participants were distributed among homemakers (42.06%), self-employed individuals (27.78%), students (10.32%), and government employees (15.08%). This distribution indicates that non-working women constitute a substantial proportion of treatment users, consistent with hypotheses related to available time for medical follow-up and the ability to invest in personal appearance. Self-employed individuals may also have greater flexibility in scheduling treatment sessions compared with salaried employees (as shown in Table 1 ). Purpose of Treatment Analysis showed that the majority of participants used botulinum toxin for cosmetic purposes (85.71%), while medical indications such as hyperhidrosis and migraine were less common. This finding indicates that cosmetic use is the primary driver for treatment in this sample. Recent studies similarly report that cosmetic applications are far more prevalent than therapeutic uses such as hyperhidrosis or migraine (as shown in Table 1 ). Type of Botulinum Toxin Notably, 46.83% of participants were uncertain about the type of botulinum toxin used, while 24.6% reported type B, 14.29% type A, and 14.29% both types at different times. Uncertainty regarding toxin type may reflect limited patient education or the relative unimportance of toxin type to patients in cosmetic contexts. This observation aligns with studies suggesting that many patients prioritize outcomes over the specific formulation of botulinum toxin used (as shown in Table 1 ). Duration of the Condition Results demonstrated variability in the duration of the condition, with most cases lasting less than one year or between one and three years, and a smaller proportion exceeding seven years. This variability reflects diverse treatment motivations and differing degrees of individual need for cosmetic or medical intervention (as shown in Table 1 ). Severity of Symptoms Before Treatment Approximately 45.24% of participants reported moderate symptoms, 32.54% mild symptoms, 17.46% severe symptoms, and 4.76% symptoms that interfered with daily life. This distribution indicates that treatment was applied across a wide spectrum of clinical severity, reflecting the inclusiveness of the study sample (as shown in Table 1 ). Time to Onset of Effect The time to noticeable treatment effect varied, with the largest proportion reporting onset within 3 days to one week (33.33%). A small subset of participants (3.17%) reported no noticeable improvement. These findings highlight interindividual variability in treatment response, which may be influenced by factors such as dosage, toxin type, injection site, and individual biological characteristics (as shown in Table 1 ). Degree of Improvement After Treatment Data showed that a substantial proportion of patients experienced marked improvement (46.83%), while 32.54% reported moderate improvement. These results indicate high treatment efficacy and are consistent with global studies documenting high satisfaction and improvement rates following botulinum toxin injections (as shown in Table 1 ). Adverse Effects Adverse effects were reported by 31.75% of participants, most commonly headache and pain or swelling at the injection site. The majority of these effects were mild and transient, reflecting the overall safety of botulinum toxin treatment and aligning with existing literature on its safety in both cosmetic and medical applications (as shown in Table 1 ). Treatment Satisfaction and Continuity Overall satisfaction was very high, with 58.73% of participants reporting being very satisfied, and the majority (84.13%) indicating an intention to continue treatment. These findings reflect successful fulfillment of patient expectations and are important for future treatment planning and follow-up strategies (as shown in Table 1 ). Additional Variables The most common number of treatment sessions was two to three sessions (44.44%), and the most frequently reported duration of effect was three to four months (29.37%). These findings provide valuable data for estimating optimal session scheduling and follow-up intervals for patients (as shown in Table 1 ). Discussing Relationship Between Botulinum Toxin Type and the Occurrence of Adverse Effects Our study demonstrated no statistically significant difference in the incidence of adverse effects between botulinum toxin type A and type B (p = 0.950). This finding is consistent with clinical reviews indicating that the overall rate of adverse events is comparable between the two toxin types when used in clinical practice, although certain specific events—such as sore throat or dry mouth—may be more frequently associated with type B in some settings. Studies comparing the two toxin types in the treatment of cervical dystonia have similarly reported no meaningful difference in overall adverse event rates, supporting the clinical safety of both toxins. The occasional association of type B with certain side effects may be attributable to differences in molecular structure and genetic composition rather than differences in the fundamental mechanism of action. Consequently, these differences do not consistently translate into statistically significant disparities in moderately sized datasets (as shown in Table 2 ). Table 2 Botulinum Toxin Type × Adverse Effects Toxin Type Yes No Total Type A 10 15 25 Type B 18 30 48 Total 28 45 73 Chi-square = 0.004 P-value = 0.950 Relationship Between Botulinum Toxin Type and Severity of Adverse Effects No significant difference was found in the severity of adverse effects between the two toxin types (p = 0.909). Existing literature suggests that variations in adverse event severity are often minimal or statistically insignificant, even when qualitative differences in pain or sensitivity are reported. Scientific evidence indicates that injection dose, administration technique, and individual patient sensitivity exert a greater influence on adverse effect severity than the toxin type itself. In this context, differences between type A and type B appear to be less impactful than other clinical factors (as shown in Table 3 ). Table 3 Botulinum Toxin Type × Severity of Adverse Effects (Only among patients with adverse effects) Toxin Type Mild Moderate Severe Total Type A 4 4 2 10 Type B 7 8 3 18 Total 11 12 5 28 Chi-square = 0.192 P-value = 0.909 Relationship Between Botulinum Toxin Type and Overall Patient Satisfaction Analysis of overall patient satisfaction revealed no statistically significant difference between botulinum toxin types A and B (p = 0.870). This aligns with clinical observations indicating that satisfaction is more closely related to patient expectations, quality of application, and the degree of clinical improvement achieved, rather than the specific toxin type used. Numerous dermatologic and cosmetic studies have reported high satisfaction rates with both toxins, demonstrating comparable outcomes in aesthetic enhancement and symptom reduction, despite minor pharmacological differences such as onset speed or duration of action (as shown in Table 4 ). Table 4 Botulinum Toxin Type × Overall Satisfaction Toxin Type Not satisfied Slightly satisfied Very satisfied Total Type A 1 7 17 25 Type B 2 14 32 48 Total 3 21 49 73 Chi-square = 0.279 P-value = 0.870 Relationship Between Botulinum Toxin Type and Duration of Effect The study did not identify a statistically significant difference in the duration of effect between the two toxin types (p = 0.791). Although some studies suggest that type A may have a relatively longer duration of action than type B when equivalent conversion doses are used, final clinical outcomes are often similar. For example, dermatologic studies have reported that the effects of type A typically last 9–16 weeks or longer, whereas type B may have a shorter duration under comparable conditions; however, these differences frequently fail to reach statistical significance in professional cohorts. Variations in duration observed in individual studies may be more attributable to dosing strategies, unit conversion, or tissue responsiveness rather than inherent characteristics of the toxin type (as shown in Table 5 ). Table 5 Botulinum Toxin Type × Duration of Effect Toxin Type 6 months Total Type A 0 2 6 10 7 25 Type B 1 3 14 20 10 48 Total 1 5 20 30 17 73 Chi-square = 1.697 P-value = 0.791 Relationship Between Botulinum Toxin Type and Degree of Improvement After Treatment No significant difference in the degree of clinical improvement was observed between the two toxin types (p = 0.937). This finding is consistent with studies demonstrating that both type A and type B are effective in reducing symptoms and improving clinical outcomes in indications such as facial wrinkles and muscle spasticity. There is a lack of strong evidence indicating superior quantitative improvement with one toxin over the other when assessed using objective measures, supporting the conclusion that clinical improvement is more strongly associated with dose, injection technique, and individual patient characteristics (as shown in Table 6 ). Table 6 Botulinum Toxin Type × Degree of Improvement Toxin Type 1 (No improvement) 2 3 (Moderate) 4 5 (Marked) Total Type A 1 0 9 3 12 25 Type B 1 2 16 8 21 48 Total 2 2 25 11 33 73 Chi-square = 0.806 P-value = 0.937 Relationship Between Botulinum Toxin Type and Time to Onset of Effect The results showed no significant difference in time to onset of effect between the two toxin types (p = 0.821). Comparative studies have suggested that type B may exhibit a slightly faster onset—often within 3–5 days compared with 4–7 days for some type A formulations—but these differences are frequently not statistically significant in clinical trials. Onset speed may also be influenced by biological factors such as toxin diffusion within muscle tissue or local concentration, rather than toxin type alone (as shown in Table 7 ). Table 7 Botulinum Toxin Type × Time to Onset of Effect Toxin Type Same day Next day 3 days–1 week 1–2 weeks > 2 weeks Total Type A 1 2 10 10 2 25 Type B 0 5 18 20 5 48 Total 1 7 28 30 7 73 Chi-square = 1.533 P-value = 0.821 Relationship Between Botulinum Toxin Type and Type of Indication (Cosmetic vs Medical) Our analysis found no statistically significant difference between botulinum toxin types A and B regarding cosmetic versus medical use (p = 0.673). This finding is consistent with the widespread application of both toxins across cosmetic indications (e.g., lines and wrinkles) and medical indications (e.g., muscle spasticity and hyperhidrosis). Scientific reviews similarly demonstrate that both toxin types can be used effectively in aesthetic and therapeutic contexts (as shown in Table 8 ). Table 8 Botulinum Toxin Type × Diagnosis (Cosmetic vs Medical) Toxin Type Cosmetic only Medical indications Total Type A 18 7 25 Type B 31 17 48 Total 49 24 73 Chi-square = 0.178 P-value = 0.673 Conclusion The present findings support the prevailing trend in the literature that botulinum toxin types A and B generally: Exhibit comparable core clinical efficacy without significant differences across multiple variables such as degree of improvement and patient satisfaction. May show minor variations in parameters such as onset speed or specific adverse effect profiles, but these differences are often not statistically decisive. Are selected primarily based on clinical context, practitioner experience, and availability rather than fundamentally different therapeutic effects, except in specific situations such as immunoresistance or prior adverse reactions. These conclusions are supported by comparative reviews in conditions such as cervical dystonia, which have not demonstrated differences in overall efficacy or major adverse events at clinically used doses. No statistically significant differences were identified between botulinum toxin type A and type B across all evaluated clinical variables, including the incidence of adverse effects, degree of improvement, patient satisfaction, duration of effect, time to onset, and type of indication. The findings support a high degree of equivalence in both efficacy and safety between the two toxin types and are consistent with the global scientific literature. Any minor differences reported in individual studies are more likely related to dosing, injection technique, or individual patient response rather than inherent distinctions between the toxin types. Recommendations Both botulinum toxin type A and type B can be used safely and effectively in medical and cosmetic applications when recommended doses and standard injection techniques are followed. Future studies with larger sample sizes are recommended to detect any subtle differences between the two toxin types. Logistic regression analyses should be employed to assess the independent effect of toxin type after adjusting for confounding variables such as age, sex, and type of indication. Long-term follow-up is advised to monitor antibody formation, particularly with type A, and to evaluate its impact on treatment efficacy. Standardized measures of patient satisfaction and clinical improvement should be adopted to enhance comparability across studies and improve the generalizability of results. Limitations The current sample size (126 cases) may be insufficient to detect subtle differences between the two toxin types. Interindividual variability in patient response to injections may have influenced outcomes and cannot be fully controlled. Limitations in documenting certain variables, such as severity of adverse effects or satisfaction level, may introduce measurement bias. Short follow-up duration for some patients may preclude adequate assessment of long-term effects or antibody development. patients who had lobectomy later required total thyroidectomy due to recurrence or malignancy detection. Declarations Author Contributions Sedra conceptualized the study, analyzed the data and wrote the original draft of the manuscript, Asia and Belal was the supervisor, all author read and approved the final manuscript, Haidar was involved in the magazine's correspondence. Funding Not applicable Clinical trial number Not applicable Declarations Ethics approval and consent to participate This research was carried out in accordance with the precepts of the Declaration of Helsinki and the Nuremberg Code, respecting the Standards for Research Involving Human Beings. In compliance with Resolution No. 466, of December 12, 2012, of the National Health Council - CNS, which includes the Guidelines and Regulatory Norms for Research involving human beings, Ethics approval and consent to participate. Ethical approval was secured from the Federal University of Rio Grande– FURG (Opinion: 4.375.697/ CAAE: 39081120.0.0000.5324. The participants were provided with detailed information on the research, including its objectives, procedures, potential risks, and benefits. Additionally, they were informed about their right to withdraw from the study at any time without repercussion. All participants agreed to participate in the study, and provided verbal or written consent. Data availability The data supporting this study's findings cannot be made publicly available to protect (patient confidentiality / sensitive information / proprietary rights). However, anonymized or limited data may be shared with qualified researches subject to approval by "the ethics committee". Requests should be directed to corresponding author's email. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References Simpson LL. The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev . 1981 Sep. 33(3):155-88. [QxMD MEDLINE Link]. Erbguth FJ, Naumann M. Historical aspects of botulinum toxin: Justinus Kerner (1786-1862) and the "sausage poison". Neurology . 1999 Nov 10. 53(8):1850-3. [QxMD MEDLINE Link]. Jeuveau (prabotulinumtoxinA) [package insert]. Santa Barbara, Calif: Evolus Inc. February 2019. Available at [Full Text]. de Paiva A, Meunier FA, Molgo J, Aoki KR, Dolly JO. Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals. Proc Natl Acad Sci U S A . 1999 Mar 16. 96(6):3200-5. [QxMD MEDLINE Link].[Full Text]. Blasi J, Chapman ER, Link E, et al. Botulinum neurotoxin A selectively cleaves the synaptic protein SNAP-25. Nature . 1993 Sep 9. 365(6442):160-3. [QxMD MEDLINE Link]. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8817828","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":600155263,"identity":"019c08a7-56a5-44ed-847d-a27ecee6dcf6","order_by":0,"name":"Sedra Alibrahim","email":"","orcid":"","institution":"Syrian Private University","correspondingAuthor":false,"prefix":"","firstName":"Sedra","middleName":"","lastName":"Alibrahim","suffix":""},{"id":600155266,"identity":"aff1b9a9-d922-4c57-96b0-1f652939d109","order_by":1,"name":"Belal Almeshaal","email":"","orcid":"","institution":"Syrian Private University","correspondingAuthor":false,"prefix":"","firstName":"Belal","middleName":"","lastName":"Almeshaal","suffix":""},{"id":600155269,"identity":"1083052d-979f-47b2-b2ae-aaedae689fc1","order_by":2,"name":"Asia Sawwan","email":"","orcid":"","institution":"Syrian Private University","correspondingAuthor":false,"prefix":"","firstName":"Asia","middleName":"","lastName":"Sawwan","suffix":""},{"id":600155272,"identity":"c498e03e-c42e-47a4-af34-232c32ef0933","order_by":3,"name":"haidar yousef","email":"data:image/png;base64,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","orcid":"","institution":"Damascus University","correspondingAuthor":true,"prefix":"","firstName":"haidar","middleName":"","lastName":"yousef","suffix":""}],"badges":[],"createdAt":"2026-02-07 20:08:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8817828/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8817828/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105228358,"identity":"962471e2-ca38-43ec-b8c9-409d3c0101b3","added_by":"auto","created_at":"2026-03-23 17:10:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1239530,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8817828/v1/f66deced-deb5-401c-ada8-5a4851b7577d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Botulinum Neurotoxins Type A \u0026B: A Comparative Cross-Sectional Study of Mechanism, Efficacy, and Clinical Applications","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBotulinum neurotoxins (BoNTs) are among the most potent biological substances known and have become widely established as essential therapeutic and cosmetic agents in modern clinical practice. Derived from Clostridium botulinum, these neurotoxins exert their effect by inhibiting acetylcholine release at the neuromuscular junction, leading to temporary, reversible muscle relaxation. Among the seven identified serotypes (A\u0026ndash;G), botulinum toxin type A (BoNT-A) and type B (BoNT-B) are the most extensively studied and clinically utilized. (1)\u003c/p\u003e \u003cp\u003eBoNT-A is the most commonly used serotype worldwide, particularly in cosmetic dermatology for the treatment of facial wrinkles and fine lines, as well as in various medical conditions such as muscle spasticity, dystonia, chronic migraine, and hyperhidrosis. BoNT-B, although less frequently used, represents an important alternative, especially in patients who develop resistance or reduced responsiveness to BoNT-A, potentially due to neutralizing antibody formation. (2)\u003c/p\u003e \u003cp\u003eDespite sharing a similar mechanism of action, BoNT-A and BoNT-B differ in their molecular structure, receptor binding profiles, pharmacodynamic properties, onset of action, duration of effect, and side-effect profiles. Several studies have suggested subtle differences between the two types, such as a faster onset but shorter duration of effect with BoNT-B, and a potentially higher incidence of autonomic side effects (e.g., dry mouth) in certain indications. However, the clinical relevance of these differences remains controversial, and published results are often inconsistent (3).\u003c/p\u003e \u003cp\u003eMoreover, while numerous studies have evaluated the efficacy and safety of each toxin individually, direct comparative studies assessing both types across a broad range of clinical and cosmetic outcomes remain limited, particularly in real-world clinical settings and in populations from the Middle East. This lack of comprehensive comparative data creates uncertainty in clinical decision-making regarding optimal toxin selection based on efficacy, safety, patient satisfaction, and indication type. (4)\u003c/p\u003e \u003cp\u003eTherefore, a comparative evaluation of BoNT-A and BoNT-B across multiple clinically relevant parameters\u0026mdash;including adverse effects, severity of improvement, patient satisfaction, duration of effect, onset time, and diagnostic use\u0026mdash;is essential to better inform evidence-based practice and optimize patient outcomes.(5)\u003c/p\u003e\n\u003ch3\u003eObjective\u003c/h3\u003e\n\u003cp\u003eThis study aims to evaluate and compare the clinical efficacy and safety of botulinum toxin type A and type B across a range of cosmetic and medical indications. The primary variables assessed include the incidence of adverse effects, severity of adverse effects, overall patient satisfaction, duration of effect, degree of clinical improvement after treatment, time to onset of effect, and type of indication (cosmetic versus medical).\u003c/p\u003e \u003cp\u003eThe study further seeks to determine whether statistically significant differences exist between the two toxin types with respect to these variables, to analyze factors influencing clinical outcomes in order to provide scientific evidence that supports selecting the most appropriate toxin for each patient, and to offer data-driven recommendations regarding the optimal use of both toxin types in cosmetic and medical applications.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSignificance\u003c/h2\u003e \u003cp\u003eThe significance of this study lies in the following aspects:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eEnhancing clinical knowledge: Despite the widespread use of both toxin types, recent literature indicates knowledge gaps regarding precise comparisons between type A and type B across various clinical parameters, such as degree of improvement and duration of effect.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSupporting clinical decision-making: The study findings may assist physicians and practitioners in selecting the most suitable toxin based on patient expectations, type of diagnosis, and responsiveness of the target muscles.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eImproving patient satisfaction: Identifying factors that influence satisfaction and duration of effect contributes to optimizing the clinical experience and reducing risks associated with repeated injections or suboptimal dosing.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eContributing to global literature: This study provides additional data that can be compared with international studies, particularly in populations or settings where extensive comparisons between the two toxin types have not been conducted.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eEvaluating medical versus cosmetic use: Understanding the relationship between toxin type and indication allows for improved treatment planning and prioritization of efficacy versus safety for each application.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInclusion and Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003e \u003cb\u003eInclusion Criteria\u003c/b\u003e Patients who received botulinum toxin type A or type B injections during the study period, Cosmetic cases, including facial and forehead wrinkles, or medical indications such as hyperhidrosis, muscle spasticity, or migraine, Availability of adequate clinical follow-up to assess all study variables (adverse effects, degree of improvement, duration of effect), Complete medical records allowing accurate classification of variables.\u003c/p\u003e \u003cp\u003e \u003cb\u003eExclusion Criteria\u003c/b\u003e Patients who received other botulinum toxin types (other than A or B), Uncertain cases or records with incomplete or inaccurate data (\u0026ldquo;not sure\u0026rdquo; or \u0026ldquo;both\u0026rdquo;), Patients with complex neuromuscular disorders that hinder accurate assessment of improvement, Patients with known hypersensitivity to botulinum toxins or previous allergic reactions preventing fair clinical comparison, Cases in which follow-up was insufficient to fully assess the duration of effect within the defined evaluation period.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e \u003cb\u003eStudy Design\u003c/b\u003e A comparative cross-sectional study design was employed. Patients were selected according to predefined inclusion and exclusion criteria to ensure the accuracy and reliability of the results. \u003cb\u003eData Collection\u003c/b\u003e Data were collected using an electronic questionnaire distributed to patients attending clinics and cosmetic centers in Damascus Governorate. Collected variables included demographic characteristics (age, sex, occupation), incidence of adverse effects, degree of improvement, satisfaction level, duration of effect, time to onset of effect, and type of indication (cosmetic versus medical). All data were carefully documented to minimize classification errors or duplication.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStatistical Analysis\u003c/b\u003e Descriptive tables were used to present the distribution of variables. Differences between toxin types were analyzed using the chi-square test for multi-category tables and Fisher\u0026rsquo;s exact test for small sample sizes or when expected cell counts were less than five, Uncertain data were excluded to ensure scientific accuracy, Statistical analysis was performed using SPSS software, version 26, Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Discussion of Results","content":"\u003cp\u003e\u003cstrong\u003eAge Group\u003c/strong\u003e Study data show that the majority of participants were aged 35\u0026ndash;50 years (53.97%), followed by the 18\u0026ndash;25-year age group (36.51%). This age distribution is consistent with the nature of cosmetic botulinum toxin treatment, as concern for aesthetic appearance increases with age and the onset of early signs of aging. These findings align with previous studies indicating that individuals aged 30\u0026ndash;50 years constitute the largest group seeking cosmetic botulinum toxin treatments, with lower demand among younger and older age groups (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eTable 1. Statistical Results\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003ePatient Age Group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026lt; 18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e18\u0026ndash;25 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e36.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e35\u0026ndash;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e53.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026ge; 50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003ePatient Sex\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e97.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e34.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e59.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEngaged\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eEducational Level\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEducational Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eUniversity degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e73.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePostgraduate degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e14.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSecondary school (High school)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e9.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eLess than secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eEmployment Status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eOccupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHomemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e42.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSelf-employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e27.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e10.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eGovernment employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e15.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eDiagnosis / Purpose of Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTreatment Indication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eCosmetic use only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e85.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHyperhidrosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e18.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMigraine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e15.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSpastic muscle pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eLip fissures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eGummy smile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eType of Botulinum Toxin Used\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eToxin Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e46.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eType B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e24.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eType A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e14.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eBoth at different times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e14.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eDuration of the Condition\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026lt; 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e30.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u0026ndash;7 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e16.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026gt; 7 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e19.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eSeverity of Symptoms Before Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSeverity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e45.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSevere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e17.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eInterfering with daily life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eTime to Onset of Treatment Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTime to Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3 days \u0026ndash; 1 week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1\u0026ndash;2 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e30.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDay 2\u0026ndash;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e22.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eAfter 2 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eFrom day one\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNo improvement noticed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eOther / unspecified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eDegree of Improvement After Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eImprovement Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5 (Marked improvement)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e46.83\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e11.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3 (Moderate improvement)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1 (No improvement)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eOccurrence of Adverse Effects\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eResponse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e31.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e61.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMaybe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eType of Adverse Effects\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eAdverse Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eHeadache\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eInjection site pain/swelling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEyelid ptosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eUnintended muscle weakness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e22.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eUndesirable cosmetic outcome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e15.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDry mouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDysphagia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eAllergic reaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eOverall Satisfaction With Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSatisfaction Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eVery satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e58.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSlightly satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e30.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNot satisfied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eIntention to Continue Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eResponse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e84.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMaybe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e11.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eSite of Hyperhidrosis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eAxilla\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e78.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSoles of feet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e8.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNot specified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e13.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eNumber of Treatment Sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber of Sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eOne session\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e15.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2\u0026ndash;3 sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e44.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4\u0026ndash;6 sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e28.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7\u0026ndash;10 sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026gt;10 sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e4.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 638px;\"\u003e\n \u003cp\u003eDuration of Injection Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026lt; 1 month\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1\u0026ndash;2 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u0026ndash;4 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e29.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e5\u0026ndash;6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e26.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e\u0026gt; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNot specified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Statistical Analysis of the Relationship Between Botulinum Toxin Type and Clinical Outcomes\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cstrong\u003eSex\u003c/strong\u003e The results demonstrated a marked predominance of female participants (97.62%) compared with males (2.38%). This trend reflects prevailing social and cultural norms, whereby cosmetic care is more common among women. These findings are consistent with existing literature indicating that females represent the majority of botulinum toxin users in most global studies (as shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e Data indicate that most participants were married (59.52%), while approximately one-third were single (34.13%). The higher proportion of married individuals may be related to greater financial and social stability, enabling them to afford cosmetic procedures. Other studies have similarly observed that married individuals tend to invest more in personal appearance than single individuals (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEducational Level\u003c/strong\u003e The study revealed that 73.81% of participants had a university-level education, and 14.29% held postgraduate degrees. This suggests that the primary users of botulinum toxin treatments are individuals with higher educational attainment, which may be associated with greater health and aesthetic awareness as well as the economic capacity to cover treatment costs. This observation is consistent with studies linking educational level to interest in cosmetic treatments and awareness of their risks and benefits (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEmployment Status\u003c/strong\u003e Participants were distributed among homemakers (42.06%), self-employed individuals (27.78%), students (10.32%), and government employees (15.08%). This distribution indicates that non-working women constitute a substantial proportion of treatment users, consistent with hypotheses related to available time for medical follow-up and the ability to invest in personal appearance. Self-employed individuals may also have greater flexibility in scheduling treatment sessions compared with salaried employees (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePurpose of Treatment\u003c/strong\u003e Analysis showed that the majority of participants used botulinum toxin for cosmetic purposes (85.71%), while medical indications such as hyperhidrosis and migraine were less common. This finding indicates that cosmetic use is the primary driver for treatment in this sample. Recent studies similarly report that cosmetic applications are far more prevalent than therapeutic uses such as hyperhidrosis or migraine (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eType of Botulinum Toxin\u003c/strong\u003e Notably, 46.83% of participants were uncertain about the type of botulinum toxin used, while 24.6% reported type B, 14.29% type A, and 14.29% both types at different times. Uncertainty regarding toxin type may reflect limited patient education or the relative unimportance of toxin type to patients in cosmetic contexts. This observation aligns with studies suggesting that many patients prioritize outcomes over the specific formulation of botulinum toxin used (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDuration of the Condition\u003c/strong\u003e Results demonstrated variability in the duration of the condition, with most cases lasting less than one year or between one and three years, and a smaller proportion exceeding seven years. This variability reflects diverse treatment motivations and differing degrees of individual need for cosmetic or medical intervention (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSeverity of Symptoms Before Treatment\u003c/strong\u003e Approximately 45.24% of participants reported moderate symptoms, 32.54% mild symptoms, 17.46% severe symptoms, and 4.76% symptoms that interfered with daily life. This distribution indicates that treatment was applied across a wide spectrum of clinical severity, reflecting the inclusiveness of the study sample (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTime to Onset of Effect\u003c/strong\u003e The time to noticeable treatment effect varied, with the largest proportion reporting onset within 3 days to one week (33.33%). A small subset of participants (3.17%) reported no noticeable improvement. These findings highlight interindividual variability in treatment response, which may be influenced by factors such as dosage, toxin type, injection site, and individual biological characteristics (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDegree of Improvement After Treatment\u003c/strong\u003e Data showed that a substantial proportion of patients experienced marked improvement (46.83%), while 32.54% reported moderate improvement. These results indicate high treatment efficacy and are consistent with global studies documenting high satisfaction and improvement rates following botulinum toxin injections (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdverse Effects\u003c/strong\u003e Adverse effects were reported by 31.75% of participants, most commonly headache and pain or swelling at the injection site. The majority of these effects were mild and transient, reflecting the overall safety of botulinum toxin treatment and aligning with existing literature on its safety in both cosmetic and medical applications (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTreatment Satisfaction and Continuity\u003c/strong\u003e Overall satisfaction was very high, with 58.73% of participants reporting being very satisfied, and the majority (84.13%) indicating an intention to continue treatment. These findings reflect successful fulfillment of patient expectations and are important for future treatment planning and follow-up strategies (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdditional Variables\u003c/strong\u003e The most common number of treatment sessions was two to three sessions (44.44%), and the most frequently reported duration of effect was three to four months (29.37%). These findings provide valuable data for estimating optimal session scheduling and follow-up intervals for patients (as shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussing","content":"\u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and the Occurrence of Adverse Effects\u003c/b\u003e Our study demonstrated no statistically significant difference in the incidence of adverse effects between botulinum toxin type A and type B (p\u0026thinsp;=\u0026thinsp;0.950). This finding is consistent with clinical reviews indicating that the overall rate of adverse events is comparable between the two toxin types when used in clinical practice, although certain specific events\u0026mdash;such as sore throat or dry mouth\u0026mdash;may be more frequently associated with type B in some settings. Studies comparing the two toxin types in the treatment of cervical dystonia have similarly reported no meaningful difference in overall adverse event rates, supporting the clinical safety of both toxins. The occasional association of type B with certain side effects may be attributable to differences in molecular structure and genetic composition rather than differences in the fundamental mechanism of action. Consequently, these differences do not consistently translate into statistically significant disparities in moderately sized datasets (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Adverse Effects\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eChi-square\u0026thinsp;=\u0026thinsp;0.004 P-value\u0026thinsp;=\u0026thinsp;0.950\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and Severity of Adverse Effects\u003c/b\u003e No significant difference was found in the severity of adverse effects between the two toxin types (p\u0026thinsp;=\u0026thinsp;0.909). Existing literature suggests that variations in adverse event severity are often minimal or statistically insignificant, even when qualitative differences in pain or sensitivity are reported. Scientific evidence indicates that injection dose, administration technique, and individual patient sensitivity exert a greater influence on adverse effect severity than the toxin type itself. In this context, differences between type A and type B appear to be less impactful than other clinical factors (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Severity of Adverse Effects (Only among patients with adverse effects)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eChi-square\u0026thinsp;=\u0026thinsp;0.192 P-value\u0026thinsp;=\u0026thinsp;0.909\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and Overall Patient Satisfaction\u003c/b\u003e Analysis of overall patient satisfaction revealed no statistically significant difference between botulinum toxin types A and B (p\u0026thinsp;=\u0026thinsp;0.870). This aligns with clinical observations indicating that satisfaction is more closely related to patient expectations, quality of application, and the degree of clinical improvement achieved, rather than the specific toxin type used. Numerous dermatologic and cosmetic studies have reported high satisfaction rates with both toxins, demonstrating comparable outcomes in aesthetic enhancement and symptom reduction, despite minor pharmacological differences such as onset speed or duration of action (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Overall Satisfaction\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot satisfied\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSlightly satisfied\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eChi-square\u0026thinsp;=\u0026thinsp;0.279 P-value\u0026thinsp;=\u0026thinsp;0.870\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and Duration of Effect\u003c/b\u003e The study did not identify a statistically significant difference in the duration of effect between the two toxin types (p\u0026thinsp;=\u0026thinsp;0.791). Although some studies suggest that type A may have a relatively longer duration of action than type B when equivalent conversion doses are used, final clinical outcomes are often similar. For example, dermatologic studies have reported that the effects of type A typically last 9\u0026ndash;16 weeks or longer, whereas type B may have a shorter duration under comparable conditions; however, these differences frequently fail to reach statistical significance in professional cohorts. Variations in duration observed in individual studies may be more attributable to dosing strategies, unit conversion, or tissue responsiveness rather than inherent characteristics of the toxin type (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Duration of Effect\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 month\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026ndash;2 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026ndash;4 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u0026ndash;6 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;6 months\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eChi-square\u0026thinsp;=\u0026thinsp;1.697 P-value\u0026thinsp;=\u0026thinsp;0.791\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and Degree of Improvement After Treatment\u003c/b\u003e No significant difference in the degree of clinical improvement was observed between the two toxin types (p\u0026thinsp;=\u0026thinsp;0.937). This finding is consistent with studies demonstrating that both type A and type B are effective in reducing symptoms and improving clinical outcomes in indications such as facial wrinkles and muscle spasticity. There is a lack of strong evidence indicating superior quantitative improvement with one toxin over the other when assessed using objective measures, supporting the conclusion that clinical improvement is more strongly associated with dose, injection technique, and individual patient characteristics (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Degree of Improvement\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (No improvement)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (Moderate)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (Marked)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eChi-square\u0026thinsp;=\u0026thinsp;0.806 P-value\u0026thinsp;=\u0026thinsp;0.937\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and Time to Onset of Effect\u003c/b\u003e The results showed no significant difference in time to onset of effect between the two toxin types (p\u0026thinsp;=\u0026thinsp;0.821). Comparative studies have suggested that type B may exhibit a slightly faster onset\u0026mdash;often within 3\u0026ndash;5 days compared with 4\u0026ndash;7 days for some type A formulations\u0026mdash;but these differences are frequently not statistically significant in clinical trials. Onset speed may also be influenced by biological factors such as toxin diffusion within muscle tissue or local concentration, rather than toxin type alone (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Time to Onset of Effect\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSame day\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNext day\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 days\u0026ndash;1 week\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026ndash;2 weeks\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;2 weeks\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eChi-square\u0026thinsp;=\u0026thinsp;1.533 P-value\u0026thinsp;=\u0026thinsp;0.821\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRelationship Between Botulinum Toxin Type and Type of Indication (Cosmetic vs Medical)\u003c/b\u003e Our analysis found no statistically significant difference between botulinum toxin types A and B regarding cosmetic versus medical use (p\u0026thinsp;=\u0026thinsp;0.673). This finding is consistent with the widespread application of both toxins across cosmetic indications (e.g., lines and wrinkles) and medical indications (e.g., muscle spasticity and hyperhidrosis). Scientific reviews similarly demonstrate that both toxin types can be used effectively in aesthetic and therapeutic contexts (as shown in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBotulinum Toxin Type \u0026times; Diagnosis (Cosmetic vs Medical)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eToxin Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCosmetic only\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedical indications\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eChi-square\u0026thinsp;=\u0026thinsp;0.178 P-value\u0026thinsp;=\u0026thinsp;0.673\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe present findings support the prevailing trend in the literature that botulinum toxin types A and B generally: Exhibit comparable core clinical efficacy without significant differences across multiple variables such as degree of improvement and patient satisfaction. May show minor variations in parameters such as onset speed or specific adverse effect profiles, but these differences are often not statistically decisive. Are selected primarily based on clinical context, practitioner experience, and availability rather than fundamentally different therapeutic effects, except in specific situations such as immunoresistance or prior adverse reactions. These conclusions are supported by comparative reviews in conditions such as cervical dystonia, which have not demonstrated differences in overall efficacy or major adverse events at clinically used doses.\u003c/p\u003e \u003cp\u003eNo statistically significant differences were identified between botulinum toxin type A and type B across all evaluated clinical variables, including the incidence of adverse effects, degree of improvement, patient satisfaction, duration of effect, time to onset, and type of indication. The findings support a high degree of equivalence in both efficacy and safety between the two toxin types and are consistent with the global scientific literature. Any minor differences reported in individual studies are more likely related to dosing, injection technique, or individual patient response rather than inherent distinctions between the toxin types.\u003c/p\u003e\n\u003ch3\u003eRecommendations\u003c/h3\u003e\n\u003cp\u003eBoth botulinum toxin type A and type B can be used safely and effectively in medical and cosmetic applications when recommended doses and standard injection techniques are followed. Future studies with larger sample sizes are recommended to detect any subtle differences between the two toxin types. Logistic regression analyses should be employed to assess the independent effect of toxin type after adjusting for confounding variables such as age, sex, and type of indication. Long-term follow-up is advised to monitor antibody formation, particularly with type A, and to evaluate its impact on treatment efficacy. Standardized measures of patient satisfaction and clinical improvement should be adopted to enhance comparability across studies and improve the generalizability of results.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eThe current sample size (126 cases) may be insufficient to detect subtle differences between the two toxin types. Interindividual variability in patient response to injections may have influenced outcomes and cannot be fully controlled. Limitations in documenting certain variables, such as severity of adverse effects or satisfaction level, may introduce measurement bias. Short follow-up duration for some patients may preclude adequate assessment of long-term effects or antibody development. patients who had lobectomy later required total thyroidectomy due to recurrence or malignancy detection.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSedra conceptualized the study, \u0026nbsp;analyzed the data and wrote the original draft of the manuscript, Asia and Belal was the supervisor, all author read and approved the final manuscript, Haidar was involved in the magazine's correspondence.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis research was carried out in accordance with the precepts of the Declaration of Helsinki and the Nuremberg Code, respecting the Standards for Research Involving Human Beings. In compliance with Resolution No. 466, of December 12, 2012, of the National Health Council - CNS, which includes the Guidelines and Regulatory Norms for Research involving human beings, Ethics approval and consent to participate. Ethical approval was secured from the Federal University of Rio Grande– FURG (Opinion: 4.375.697/ CAAE: 39081120.0.0000.5324. The participants were provided with detailed information on the research, including its objectives, procedures, potential risks, and benefits. Additionally, they were informed about their right to withdraw from the study at any time without repercussion. All participants agreed to participate in the study, and provided verbal or written consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting this study's findings cannot be made publicly available to protect (patient confidentiality / sensitive information / proprietary rights). However, anonymized or limited data may be shared with qualified researches subject to approval by \"the ethics committee\". Requests should be directed to corresponding author's email.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eSimpson LL. The origin, structure, and pharmacological activity of botulinum toxin. \u003cem\u003ePharmacol Rev\u003c/em\u003e. 1981 Sep. 33(3):155-88. [QxMD MEDLINE Link].\u003c/li\u003e\n \u003cli\u003eErbguth FJ, Naumann M. Historical aspects of botulinum toxin: Justinus Kerner (1786-1862) and the \u0026quot;sausage poison\u0026quot;. \u003cem\u003eNeurology\u003c/em\u003e. 1999 Nov 10. 53(8):1850-3. [QxMD MEDLINE Link].\u003c/li\u003e\n \u003cli\u003eJeuveau (prabotulinumtoxinA) [package insert]. Santa Barbara, Calif: Evolus Inc. February 2019. Available at [Full Text].\u003c/li\u003e\n \u003cli\u003ede Paiva A, Meunier FA, Molgo J, Aoki KR, Dolly JO. Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals. \u003cem\u003eProc Natl Acad Sci U S A\u003c/em\u003e. 1999 Mar 16. 96(6):3200-5. [QxMD MEDLINE Link].[Full Text].\u003c/li\u003e\n \u003cli\u003eBlasi J, Chapman ER, Link E, et al. Botulinum neurotoxin A selectively cleaves the synaptic protein SNAP-25. \u003cem\u003eNature\u003c/em\u003e. 1993 Sep 9. 365(6442):160-3. [QxMD MEDLINE Link].\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Botulinum Toxin Type A, Botulinum Toxin Type B, Cosmetic Application, Clinical efficacy, Adverse Effects","lastPublishedDoi":"10.21203/rs.3.rs-8817828/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8817828/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eBotulinum toxin type A and type B are widely used in cosmetic and medical practice due to their neuromuscular blocking properties. Although both toxins share a similar mechanism of action, differences in pharmacological characteristics have raised questions regarding their comparative efficacy, safety, and clinical applications. Direct comparative data across multiple outcome measures remain limited.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study aimed to compare the clinical efficacy and safety of botulinum toxin type A and type B in cosmetic and medical indications, and to assess whether statistically significant differences exist between the two types with respect to adverse effects, severity of improvement, patient satisfaction, duration of effect, time to onset, and type of diagnosis. Methods A comparative cross-sectional study was conducted involving 126 patients who received either botulinum toxin type A or type B injections for cosmetic or medical purposes. Data were collected using a structured electronic questionnaire and included demographic variables, clinical outcomes, adverse effects, satisfaction levels, duration and onset of effect, and indication type. Statistical analysis was performed using descriptive statistics, chi-square tests, and Fisher\u0026rsquo;s exact tests where appropriate. Statistical significance was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eNo statistically significant differences were observed between botulinum toxin type A and type B in terms of incidence or severity of adverse effects, degree of clinical improvement, overall patient satisfaction, duration of effect, time to onset, or diagnostic use (cosmetic versus medical). Both toxin types demonstrated comparable efficacy and safety profiles across all evaluated parameters.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eBotulinum toxin type A and type B exhibit a high degree of clinical equivalence in terms of efficacy, safety, and patient-reported outcomes in both cosmetic and medical applications. The choice between the two toxins should therefore be guided by clinical context, practitioner experience, availability, and individual patient factors rather than expectations of substantial differences in therapeutic performance.\u003c/p\u003e","manuscriptTitle":"Botulinum Neurotoxins Type A \u0026amp;B: A Comparative Cross-Sectional Study of Mechanism, Efficacy, and Clinical Applications","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-05 11:18:57","doi":"10.21203/rs.3.rs-8817828/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"58153de7-f810-4aa3-8593-8cc0d235c5ef","owner":[],"postedDate":"March 5th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T17:09:42+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-05 11:18:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8817828","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8817828","identity":"rs-8817828","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}