Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Jan;24(1):e16754.
doi: 10.1111/jocd.16754.

Intradermal Incobotulinum Toxin A for Postbreast Cancer Treatment Asymmetry: A Literature Review and Case Report

Alejandra Bugallo  1 , Luis Alberto Parra  2 , Andreina Martinez Amado  3 , Victoria De la Fuente  4 , Evalicia Murúa  5 , Eliana Garcés  6 , Andrea Marcela Parra  7
Affiliations
Case Reports

Intradermal Incobotulinum Toxin A for Postbreast Cancer Treatment Asymmetry: A Literature Review and Case Report

Alejandra Bugallo et al. J Cosmet Dermatol. 2025 Jan.

Abstract

Background: Botulinum toxin (BTX) is globally the most common aesthetic procedure. Its usage has expanded beyond facial treatments to therapeutic areas, including managing scars and postsurgical deformities. Breast cancer survivors often face significant deformities and asymmetry during recovery.

Objectives: This study systematically reviewed literature from the past 4 years on botulinum toxin applications in breast cancer survivors and presented a case report of a patient treated with Incobotulinum toxin (IncoBonTA; Xeomin, Merz Pharmaceuticals GmbH, Frankfurt, Germany) for left breast deformity postchemotherapy and radiotherapy.

Methods: Following PRISMA guidelines, a systematic search was conducted on PubMed and Scopus using keywords: "botulinum toxin," "breast cancer," and "breast asymmetry," identifying relevant literature from 2020 to 2024. Five full-text articles were included. Additionally, a 2024 case report of a patient with significant breast asymmetry postsurgery and radiotherapy was published.

Results: The literature review indicated botulinum toxin's primary uses in breast cancer include pain management, upper limb impairment, postsurgical scars, and capsular contracture. Although some benefits were reported, further research is needed. In the case report, the patient was treated in one session with IncoBonTA at two different dilutions based on contracture severity without complications.

Conclusion: The review showed promising advances in using botulinum toxin for deformities secondary to oncological treatment in breast cancer patients. The therapy was administered to a 53-year-old patient, resulting in significant aesthetic improvement, especially at the nipple and areola, suggesting that it was a viable option for these patients.

Keywords: aesthetics; botulinum toxin; breast asymmetry; breast cancer; breast reconstruction; postbreast cancer treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart [8].
FIGURE 2
FIGURE 2
Before photo, left breast skin contracture and asymmetry after cancer surgery and radiotherapy are especially evident in the upper right quadrant of the areola.
FIGURE 3
FIGURE 3
IncoBonTA areas of application: Two different dilutions were applied.
FIGURE 4
FIGURE 4
Improved symmetry and overall appearance 15 days post‐treatment (A: before, B: after). Additional periareolar toxin (20 IU) administered during the initial session (red dots visible).
See this image and copyright information in PMC

References

    1. Cancer – World Health Organization (WHO) , “Breast Cancer,” (2023), https://www.paho.org/en/topics/breast‐cancer.
    1. Siegel R. L., Giaquinto A. N., and Jemal A., “Cancer Statistics, 2024,” CA: A Cancer Journal for Clinicians 74, no. 1 (2024): 12–49. - PubMed
    1. Najmiddinov B., Park J. K.‐H., Yoon K.‐H., et al., “Conventional Versus Modified Nipple Sparing Mastectomy in Immediate Breast Reconstruction: Complications, Aesthetic, and Patient‐Reported Outcomes,” Frontiers in Surgery 9 (2022): 1001019. - PMC - PubMed
    1. do Espirito Santo P. R. Q., Veiga D. F., Boggio R. F., et al., “Mammoplasty: Steps for Safe Surgery. Evidence From Literature,” Revista Brasileira de Cirurgia Plástica 36 (2022): 366–372.
    1. Bekisz J. M., Boyd C. J., Salibian A. A., Choi M., and Karp N. S., “Aesthetic Characteristics of the Ideal Female Breast,” Plastic and Reconstructive Surgery. Global Open 11, no. 1 (2023): e4770. - PMC - PubMed

MeSH terms

Substances