The effect of incobotulinumtoxin a and dermal filler treatment on perception of age, health, and attractiveness of female faces

Objectives: Facial age, health, and attractiveness assessments play a major role in human social interaction and affect the way we perceive and think about others. Modern cosmetic dermatology provides a bewildering array of facial treatment procedures with botulinum toxin type A and dermal filler application being the most requested. The authors sought to determine the effect of facial rejuvenation procedures, such as application of incobotulinumtoxin A and dermal filler injections, on people's perception of age, health, and attractiveness. Methods: Ten women underwent three consecutive facial rejuvenation procedures with incobotulinumtoxin A, calcium hydroxylapatite, and a hyaluronic acid. Digital facial images were taken before treatment and after each subsequent treatment and presented to a total of 150 third-party assessors who judged the images for age, health, and attractiveness. Results: Each procedure was associated with a significant reduction in perceived age and an increase in perceived health and attractiveness compared with pre-treatment images. The effects were cumulative such that faces perceived as the youngest, healthiest, and most attractive had received all three treatments, followed in descending order by incobotulinumtoxin A and calcium hydroxylapatite treatment, and incobotulinumtoxin A alone. Conclusion: The authors demonstrate that naive judges are readily able to perceive the effect of nonsurgical facial rejuvenation procedures with incobotulinumtoxin A, calcium hydroxylapatite, and hyaluronic acid in terms of age, health, and attractiveness judgments. These effects were greatest when incobotulinumtoxin A and dermal filler treatments were combined.