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Ana Lucia Gonzaga da Cunha,1 Rossana Vasconcelos,2 David Di Sessa,3 Gabriel Sampaio,4 Pitila Ramalhoto,5 Bruno F Zampieri,6 Bárbara S Deus,7 Suyan Vasconcelos,8 Talitha Bellote,9 Juiano Carvalho,10 Giseli Petrone,5 Vinicius Figueredo,11 Gustavo Limongi Moreira3 1Clínica Skinline, Santo André, SP, Brazil; 2Nomina Clinica Médica De Cirurgia Plástica, Dermatologia e Oncologia, São Paulo, SP, Brazil; 3DSL Clínica Médica, São Paulo, SP, Brazil; 4Host Clínica, São Paulo, SP, Brazil; 5Private Clinic, Rio de Janeiro, RJ, Brazil; 6Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil; 7Clinica Avatié, São Paulo, SP, Brazil; 8Clinica Splendore, Aracaju, SE, Brazil; 9Instituto La Beautè, Curitiba, PR, Brazil; 10Private Clinic, São Paulo, SP, Brazil; 11Host Clinica, São Paulo, SP, BrazilCorrespondence: Gustavo Limongi Moreira, DSL Clínica Médica, Rua Pamplona 145 / 1717, Jardim Paulista, Sao Paulo, SP, 01405-900, Brazil, Email drgustavolimongi@gmail.comBackground: There is substantial interpersonal variation in the patterns of muscular contraction that substantiates the use of personalized points of application and dosages in clinical practice to achieve optimal results. Nevertheless, there has been no real-life therapeutic series with botulinum toxin for aesthetic treatment of the face in which the subjects were systematically followed to assess its long-term benefit.Purpose: To assess the performance and length of the treatment of glabellar and forehead lines with IncobotulinumtoxinA in a real-life setting.Patients and Methods: We enrolled 20 adults with indications for the treatment of upper facial dynamic lines (glabella and forehead) with botulinum toxin. The protocols of injection points were personalized by the injectors. The participants were photographed under maximum facial contraction before the application (D0) and after 15, 90, 120, and 180 days. The photos were randomly assessed by two blinded experienced raters to consensually grade the dynamic lines according to the Merz Aesthetics Scales (MAS). Efficacy was defined as the reduction in the MAS score.Results: At D15, 18 (90%; 95% CI: 80%– 100%) participants reached the zero score, or a 2-point reduction on the MAS score from the forehead and 16 (80%; 95% CI: 65– 90%) reached that reduction for the glabella. These values from D90 were 14 (70%; 95% CI: 55– 85%) for both sites. At D120, these values were 11 (55%; 95% CI: 35– 75%) and 8 (40%; 95% CI: 25– 55%) for the forehead and glabella. At D180, 10 (50%; 95% CI: 30– 70%) participants presented a MAS score for forehead or glabella dynamic lines lower than the score assessed at D0.Conclusion: As much as 70% of the patients sustained a reduction of scores after 120 days of the treatment for dynamic glabellar and forehead lines. Half of the patients evidenced prolonged benefit at 180 days.Keywords: incobotulinumtoxinA, botulinum toxin, injection technique, ONE21, dynamic wrinkles, upper face, Xeomin