The tension acting on the wound edge is an important factor determining the appearance of scars after wound healing.27 BTXA can cause temporary muscle paralysis in the wound and reduce the tension perpendicular to the edge of the wound10,28; therefore, BTXA can partially eliminate the dynamic tension on the wound. It can also significantly reduce collagen deposition, thereby preventing the formation of scars.29 Lastly, BTXA may affect the cell cycle of fibroblasts resulting in inhibition of scar hyperplasia.30