Aesthetic Plastic Surgery

, Volume 42, Issue 6, pp 1664–1671 | Cite as

Efficacy and Safety of Botulinum Toxin Type A Injection in Patients with Bilateral Trapezius Hypertrophy

  • Rong-Rong Zhou
  • Hui-Ling Wu
  • Xu-Dong Zhang
  • Li-Li Ye
  • Hui-Jun Shao
  • Xin-Hui Song
  • Ming-Li Song
  • Shu-Sen ZhengEmail author
Original Article Non-Surgical Aesthetic



To evaluate aesthetic outcomes in patients with bilateral trapezius hypertrophy treated by botulinum toxin type A (BTxA) injection for aesthetic reconstruction of the upper trapezius.


From May 2015 to May 2016, 30 women with a short neck shape resulting from bilateral trapezius hypertrophy were treated with botulinum toxin type A (BTxA) injection at the most affected area of the upper trapezius. Pre- and postoperative values of SACDF (irregularly shaped area of the four points A, C, D, and F) and SACDE (irregularly shaped area of the four points A, C, D, and E), responses to patients’ and doctors’ Global Aesthetic Improvement Scale (GAIS) questionnaires for neck aesthetic assessment, as well as reported adverse events, were recorded and analyzed.


Duration of follow-up ranged from 4 to 12 months. Subjects experienced non-severe adverse events and complete recovery after a single BTxA injection. In patients’ GAIS questionnaires, “very much improved” accounted for 53%, “much improved” accounted for 13%, and “improved” accounted for 27%. In doctors’ GAIS questionnaires, “very much improved” accounted for 27%, “much improved” accounted for 33%, “improved” accounted for 33%, and “no change” accounted for 7%. The overall degree of improvement was high. Statistically significant differences were observed with respect to the “very much improved” response to GAIS questionnaires between patients and doctors (P = 0.035).


A single injection of BTxA for aesthetic reconstruction of the upper trapezius is safe and effective in patients with bilateral trapezius hypertrophy.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Bilateral trapezius hypertrophy Botulinum toxin type A Upper trapezius 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the institutional ethics committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the Declaration of Helsinki (1964) and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Rong-Rong Zhou
    • 1
    • 2
  • Hui-Ling Wu
    • 3
  • Xu-Dong Zhang
    • 2
  • Li-Li Ye
    • 2
  • Hui-Jun Shao
    • 2
  • Xin-Hui Song
    • 4
  • Ming-Li Song
    • 4
  • Shu-Sen Zheng
    • 1
    Email author
  1. 1.Division of Hepatobiliary and Pancreatic Surgery, Department of SurgeryFirst Affiliated Hospital, School of Medicine, Zhejiang UniversityHangzhouChina
  2. 2.Department of Burn and Plastic SurgeryPLA 117 HospitalHangzhouChina
  3. 3.Department of Plastic and Cosmetic SurgeryFirst Affiliated Hospital, School of Medicine, Zhejiang UniversityHangzhouChina
  4. 4.College of Computer ScienceZhejiang UniversityHangzhouChina

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