Patient Satisfaction After OnabotulinumtoxinA Treatment and Jowl Reduction With Deoxycholic Acid

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botox patient satisfaction

Patient Satisfaction and Perceptions of Patients’ Family or Significant Other After OnabotulinumtoxinA Treatment: A Prospective Cross-Sectional Study

José Raul Montes, MD, FACS, FACCS* and Ruhi V. Ubale, PhD

jowl reduction dca

Jowl Reduction With Deoxycholic Acid

José Raul Montes, MD, FACS, FACCS, *Elizabeth Santos, MPH, Dr PH, *and Annirudha Chillar, MD, PhD


The study proposes a novel protocol for targeting the jowls using deoxycholic acid (DCA) injections, with emphasis on safety and feasibility of the procedure.

This prospective study was conducted at a cosmetic practice between June 2016 and May 2017. Twelve consecutive patients seeking reduction / improvement in mild / moderate jowl fat were injected with DCA subcutaneously in a predefined circular area 1.0 cm above the mandibular border. Treatment response was assessed using physician-evaluated Global Aesthetic Improvement Scale (GAIS) and Subject GAIS.

Twelve patients (11 women and 1 man) with mild (n=8) or moderate (n=4) jowls were treated. After the first treatment, GAIS responses for 24 jowls showed 5 jowls with vast improvement, 15 with moderate improvement, and 4 with no change. After the second session for 5 jowls in 3 patients, GAIS responses showed vast improvement in 4 jowls and moderate improvement in 1. Adverse events included induration (n=4), bruising (n=6), numbness (n=2), pain (n=5), redness (n=3), edema (n=9), and dysphagia (n=1).

Results of this early experience showed that DCA injections were safe and effective for non surgical jowl reduction. Supported by a publication grant from Allergan Inc. A. Chillar is an employee of Cactus Communications, who was funded by Allergan for providing writing and editorial assistance. The authors have indicated no significant interest with commercial supporters.

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