ArticleClinical, cosmetic and investigational dermatology2026
A Multimodal Approach to Extended Periorbital Rejuvenation: Clinical Outcomes and Time Course in a Prospective Single-Centre 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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Abstract
Background: The periorbital region is characterized by early visible signs of aging, including wrinkles, fine lines, and skin laxity. While surgical procedures such as blepharoplasty have traditionally been used to address these changes, minimally invasive aesthetic treatments such as polynucleotides (PNs), botulinum toxin, and hyaluronic acid (HA) fillers are increasingly preferred due to lower risks and shorter recovery times. Although these treatments are widely used, real-world data on the efficacy and safety of such combination protocols remain limited. Objective: To assess the time course and safety of a comprehensive holistic rejuvenation procedure using highly crosslinked HA-based fillers, PNs, and letibotulinumtoxinA in the extended periorbital region. Materials and Methods: In this prospective, non-interventional study, 34 participants with a mean age of 41.2 ± 11.4 years received an extended periorbital treatment comprising injections of an HA-based filler at Visit 1, polynucleotide at Visit 1, 2 and 3 and letibotulinumtoxinA at Visit 3 (Week 6). A mean total of 1.38 ± 0.37 cc HA-based filler was administered per patient. Skin wrinkling in the periorbital region was assessed using VISIA skin analysis, while glabellar line severity and midface volume deficit were evaluated using the Facial Wrinkle Scale (FWS) and Midface Volume Deficit Severity Scale (MVDSS), respectively. Assessments were performed by the principal investigator at baseline, week 8, and week 22. Results: VISIA analysis showed no statistically significant change in periorbital wrinkling at Week 8 (+1.6% vs baseline) and by Week 22 (-5.1%). Mean FWS scores improved from 2.9 at baseline to 1.6 at Week 8 and 2.4 at Week 22, while MVDSS scores improved from 2.6 at baseline to 1.1 at Week 8 and remained improved at 1.3 at Week 22; all changes from baseline were statistically significant. Two non-serious injection site reactions (5.9%) were reported. Conclusion: This study describes the real-world time course of a multimodal approach targeting muscle activity, volume loss, and skin quality in the extended periorbital region. Larger, longer and ideally controlled studies are required to characterize the safety and efficacy of such staggered multimodal treatment approaches.
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