Periocular Rejuvenation Research Articles

A Comprehensive Review of Use of Neurotoxins for Periocular Rejuvenation.

A Comprehensive Review of Use of Neurotoxins for Periocular Rejuvenation.

Protocol Establishment and Reliability Verification of Three-Dimensional Digital Stereophotogrammetry in Lower Eyelid Anthropometry.

Three-dimensional (3D) stereophotogrammetry has been widely used in anthropometry for both medical and esthetic purposes. However, no studies have assessed its reliability on measuring the lower eyelid by 3D imaging. This study aimed to establish a standardized 3D anthropometric protocol for lower eyelid region and validate its reliability. Fifty-eight participants (116 eyes) were recruited with mean age of 39.14 ± 11.25 years. Two sets of VECTRA 3D images were taken for each subject, and each set of images was individually measured twice by two raters. Twenty-seven landmarks were identified in the lower eyelid region, and then 19 linear, 4 curvilinear, 7 angular and 2 areal metrics were assessed for intrarater, interrater and intramethod reliability. High reliability was found in this 3D imaging-based lower eyelid anthropometry. The mean absolute difference within 2 intrarater measurement were 0.22 and 0.08 units, the technical errors measurement were 0.31 and 0.15 units, the relative errors of measurement were 0.90% and 0.31%, the relative technical errors of measurement were 1.53% and 0.64%, and the intra-group correlation coefficient was 0.99 and 0.99. The results for interrater measurement were 0.53 units, 0.59 units, 2.94%, 3.41% and 0.96, and for intramethod measurement were 0.71 units, 0.77 units, 4.12%, 4.05% and 0.95 units, respectively. 3D stereophotogrammetry is reliable for lower eyelid anthropometry. The standardized protocol can be further applied for many purposes such as lower eyelid aging evaluation, surgical related assessment and periocular rejuvenation plan. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Tear trough rejuvenation using Restylane Eyelight

Hyaluronic acid filler injection treatment represents the second most commonly performed non-surgical treatment worldwide behind botulinum toxin injections ( International Society of Aesthetic Plastic Surgery, 2020 ). This should come as no surprise, as dermal filler treatments represent a swift non-surgical technique with immediate and long-lasting results. Consequently, such treatments are gaining global acceptance ( Berguiga and Galatoire, 2017 ). It is known that periocular rejuvenation is one of the chief concerns for patients seeking aesthetic enhancement ( Eyelight, 2020 ). Therefore, it is the author's belief that possessing the expertise to carry out tear trough rejuvenation is an important skill to acquire in one's medical practice. To achieve ideal results, the aesthetic practitioner must have an innate knowledge of anatomy, as well as assessment and treatment techniques of the area. This article will review the evidence relating to hyaluronic acid dermal fillers and the clinical outcomes for patients who require tear trough treatment.

Efficacy and tolerability of a novel skin cream for improving periocular rhytids and dryness.

A novel topical cream was developed to address the appearance of aging periorbital skin. The goal of this study was to evaluate the efficacy and tolerability of this product (Total Eye® Firm & Repair Cream; Colorescience, Inc., Carlsbad, CA) for improving periorbital wrinkles, dryness, laxity, and dark circles. This 8-week open-label trial enrolled subjects 35-65 years old seeking periocular rejuvenation (N=25; 22 female, 3 male). The product was applied each morning and evening after facial cleansing. Study endpoints were changes in Investigator Clinical Grading and Eye Appearance Assessments, Subject Self-assessment Questionnaires, and tolerability after 4 and 8 weeks of treatment. Among subjects completing the study (n=23), all (100%) showed some global improvement at Weeks 4 and 8 and almost half (48%) achieved moderate or marked improvement. Improvements were observed for all parameters and were most pronounced for wrinkles, laxity, and dark circles. Improvements for laxity and dryness were significant by Week 4 and for dark circles by Week 8. At Week 8, subjects agreed or strongly agreed that the product made their eyes feel more hydrated (100%), look and feel healthier (95%), and increased confidence in their eye appearance (91%). The product was well-tolerated. Modest number of subjects and open-label study design. Twice-daily Total Eye® Firm & Repair Cream improved the overall appearance of the periorbital area. The product was well-tolerated and most treated subjects were satisfied with their results. The product is a viable option for treating periorbital wrinkles and laxity and should be considered a safe and effective skincare option.

Periocular rejuvenation using a unique non-ablative long-pulse 2940\xa0nm Er:YAG laser

The periocular region is challenging for cosmetic laser surgeons. Surgery and laser resurfacing have traditionally been used to correct periorbital lines and wrinkles. Although effective, the associated downtime with these methods has made many people reluctant to decide for such treatments. More recently, the non-ablative long-pulse 2940 nm Er:YAG laser is being used to improve the structure and function and hence the appearance of skin in the periorbital region. The objective of this study is to evaluate the safety and efficacy of long-pulse 2940 nm Er:YAG laser for non-ablative treatment of periorbital static wrinkles and skin laxity. This is a prospective analysis of 30 patients treated for periorbital rejuvenation using three sessions of non-ablative long-pulse Er:YAG laser over a 3-month period. All patients were assessed according to Fitzpatrick’s classification of periorbital wrinkles to class I, II, or III and were treated with 2940 nm Er:YAG laser using a fluence of 3.75 J/cm2, a repetition rate of 1.7–2 Hz, and with the SMOOTH™ pulse mode (250 ms). The treatment sessions were performed on each patient, 4 weeks apart. Patient improvement was assessed before each laser session as well as at 12 months after the final treatment. Blind photographic evaluations were performed by three independent physicians using unlabeled before and after photos arranged in non-chronological order. Reviewers were asked to determine the before and after photos. Patients were asked to answer a questionnaire measuring satisfaction 4 weeks after each session, and to report any adverse reactions. There was statistically and clinically significant improvement in the Fitzpatrick classification of the periorbital wrinkles. Blinded evaluators correctly identified the before and after photos in all cases. All patients reported mild edema and erythema, which persisted for 1 to 2 days, and superficial peeling of the skin for 4 to 6 days after each laser treatment. No long-term adverse effects were reported. The non-ablative long-pulse 2940 nm Er:YAG laser seems to be a safe and effective treatment for periocular rejuvenation with minimal and tolerable adverse reaction. The improvement attained from the laser sessions was persisting after 1 year denoting the long-term efficacy of the procedure.

An approach and algorithm for optimal periocular rejuvenation

The periocular area is one of the first areas to show the signs of facial ageing. These signs occur for a variety of reasons, including loss of collagen and soft tissue changes, bone resorption and facial fat pad descent and degradation. There are many variables that impact an individual's ability to age at an accelerated or slower rate, based on various topical skin applications, energy- and non-energy-based skin regeneration therapies and lifestyle choices and the internal ageing processes specific to each individual. In this article, from a Canadian perspective, the author will discuss a treatment algorithm to provide optimal rejuvenation in the delicate and hypermobile periocular area, while taking into consideration patient safety, coupled with clinically efficacious rejuvenation options.

Periocular rejuvenation using hyaluronic acid fillers

The eyes and periocular region are critical for emotive display and play a key role in social interactions. This region includes the upper and lower eyelids, brow-lid complex, and lid-cheek complex. Perturbances in this area can lead to a prematurely aged appearance and patients complain of emotive misinterpretation. It often shows the earliest signs of facial aging, leading to a tired, sad, or angry appearance. With the evolution of medical and surgical knowledge on facial aging, there has been a shift from isolated volume reducing interventions for periorbital aging to volume replacement techniques. The treatment of periocular aging is multifactorial and often includes resurfacing, chemodenervation, surgical interventions, and volumization. The minimally-invasive, office-based nature of fillers has resulted in their increased popularity and filler placement has become one of the most commonly performed cosmetic oculoplastic interventions. With a multitude of fillers emerging over the past decade or so, facial plastic surgeons have been equipped with the means to address age-related periorbital hollowing and skeletonization in an outpatient setting. An appropriate knowledge of periocular anatomy, types of fillers, proper injection technique, and management of potential complications is required for safe injection and to achieve optimal aesthetic outcomes. This paper reviews the use of hyaluronic acid fillers for periocular rejuvenation.

Comparison of the effects of polynucleotide and hyaluronic acid fillers on periocular rejuvenation: a randomized, double-blind, split-face trial

Background Filler injection has become an extremely popular method for facial skin rejuvenation, including the periorbital area. In the recent years, new polynucleotide (PN)-containing filler products have been used for esthetic purposes. Aim We aimed to investigate the efficacy and safety of PN filler injection in the periorbital area. Patients/methods A total of 27 subjects were enrolled in this randomized, pair-matched, and active-controlled study. Each subject received filler injections thrice with two-week intervals, with a PN filler injection on one side and a non-crosslinked hyaluronic acid (HA) filler injection on the contralateral side of the periorbital area. Results Improvements in the visual analog scale and global esthetic improvement scale scores were not significantly different between the PN and HA groups. The improvement rates of skin elasticity and hydration decreased over time in both groups, with the PN group showing a higher improvement rate. The improvement rates of roughness and pore volume were higher in the PN group than in the HA group. The improvement rate of dermal density was not significantly different between the groups. No serious adverse events were reported. Conclusion The PN filler injection is effective and safe for periorbital rejuvenation.

Rejuvenation of periocular region in Koreans: A multimodal approach combining botulinum toxin, fillers, and micro-focused ultrasound with visualization for optimal results.

Periorbital aging involves all layers of the skin, fat, and the bony orbit. Therefore, a multimodal approach is necessary. Twenty Korean subjects who required periorbital rejuvenation were enrolled in this study. First, micro-focused ultrasound with visualization (MFU-V) was performed across the supra-brow area, lateral canthus, and the infraorbital area. Next, the filler was injected into the sunken upper eyelid, lateral eyebrow, and the infraorbital area. Lastly, botulinum toxin was administered into the forehead, glabella, crow's feet, and the lateral orbital rim below the brow on the same day. Photographs were taken at baseline; immediately after treatment; and at 1, 4, and 12 weeks of follow-up. The average eyebrow height was increased by 3.5 mm, and the maximum height was elevated by 3.9 mm at week 12. Physician visual analogue scale (VAS) scores regarding the whole periorbital area and eyebrow ptosis were continuously improved throughout the observation period. Physician VAS scores for infraorbital hollow and superior sulcus deformity improved immediately after the procedure and were maintained at week 12. Adverse events were mild and transient. We believe that a multimodal approach combining MFU-V, fillers, and botulinum toxin results in significant periocular rejuvenation.

Periocular rejuvenation with neurotoxin and dermal filler

Periocular rejuvenation with neurotoxin and dermal filler

Minimal Undermining Suspension Technique (MUST): An Innovative Technique for Mini-Invasive Approach for Periocular Rejuvenation

Minimal Undermining Suspension Technique (MUST): An Innovative Technique for Mini-Invasive Approach for Periocular Rejuvenation

Volumetric Eyebrow Lifting with the Aid of a New Hyaluronic Acid Dermal Filler (Intraline) and Upper Surgical Blepharoplasty; Enhancing Outcomes

Abstract Periocular aging is characterized for a volumetric skeletonization of the orbit, eyebrow ptosis and dystrophic changes in the eyelids skin, such as blepharochalasis, dyschromia and elastosis. Frequently only part of this elements are addressed, with incomplete resolution of the inestetisms, unnatural results and unsatisfied patients. Private setting patients with wishes of periocular rejuvenation were given combined approach of volumetric eyebrow lifting with the aid of a new hyaluronic acid dermal filler (Intraline Canada Inc, Kelowna BC, Canada) and upper surgical blepharoplasty. Through this combined method both volumetric changes, ptosis and blepharochalasis were corrected, and results in the short and medium term were satisfactory for both patients and surgeon. No complications were observed and the lengthening of the primary surgery was minimal in experienced hands.

Nonsurgical periocular rejuvenation

To review the current literature regarding aesthetic enhancement using facial neuromodulators and fillers and to present advanced techniques using facial injectables for periocular rejuvenation. The authors provide a summary of traditional periocular locations for the injection of neuromodulators and dermal fillers. The authors also present novel and advanced techniques utilizing injectables in the periocular region. Minimally invasive procedures with little-to-no recovery time are continuing to increase in popularity. Neuromodulators and hyaluronic acid gel fillers have been shown to be well tolerated and efficacious nonsurgical alternatives in periocular rejuvenation.

Perspective: rejuvenation of the periocular region: a unified approach to the eyebrow, midface, and eyelid complex.

In Brief The authors review a proven surgical technique for eyebrow and midface lifting through a minimal-incision browlift approach as part of a global periocular rejuvenation strategy.