ArticleClinical, cosmetic and investigational dermatology2026
Efficacy and Safety of Microneedle Fractional Radiofrequency Combined with Botulinum Toxin Type A for Periorbital Aging: A Retrospective Cohort Study.
Article in Clinical, cosmetic and investigational dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Purpose: To compare botulinum toxin type A (BoNT/A) alone with a single session of microneedle fractional radiofrequency (MFRF) followed by BoNT/A for periorbital aging. Patients and Methods: This retrospective cohort study included 35 patients treated between May 2022 and May 2025. Patients received BoNT/A alone (n=20) or one MFRF session followed by BoNT/A 1 week later (n=15). Dynamic crow's feet, static crow's feet, static infraorbital fine lines, the Global Aesthetic Improvement Scale (GAIS), skin biophysical parameters, and adverse events were evaluated through week 24; patient satisfaction was assessed at week 12. Results: Dynamic crow's feet improved from baseline through week 16 in the BoNT/A group and through week 24 in the MFRF + BoNT/A group. Static crow's feet improved through week 12 and week 24, respectively. No individual follow-up comparison for static infraorbital fine lines remained significant after exact Wilcoxon testing and Holm adjustment. No between-group difference in wrinkle scores remained significant after Holm adjustment. GAIS was higher with combination treatment at week 16 (adjusted p=0.004). Compared with BoNT/A alone, the combination group showed a greater change in hydration at week 24 (adjusted p=0.021), greater improvement in elasticity at weeks 12, 16, and 24 (adjusted p≤0.002), and a transient increase in transepidermal water loss at week 2 (adjusted p<0.001). Procedural adverse events were transient, and no serious adverse events were documented. Conclusion: Both regimens improved dynamic and static crow's feet during early and intermediate follow-up. In exact multiplicity-adjusted within-group analyses, late improvement was not consistently maintained in the BoNT/A-alone group, whereas the combination group remained improved through week 24; however, no between-group wrinkle-score difference was statistically significant. In this small, predominantly female cohort, the combination regimen was associated with greater improvement in selected skin-quality outcomes. Larger prospective studies using standardized multi-session MFRF protocols are needed.
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