title: Remodeling of periorbital, temporal, glabellar, and crow's feet areas with hyaluronic acid and botulinum toxin.
abstract: Botulinum toxins are currently used to reduce facial muscle activity, and hyaluronic acid is used to correct volume loss. This study evaluates the combination of abobotulinumtoxinA (Dysport) and hyaluronic acid 20 mg/mL (Perlane) for rejuvenating specific areas of the upper face. Subjects (n = 20) with mild to moderate temporal volume loss as well as glabellar and/or periorbital rhytids were enrolled in this single-center, open-label, nonrandomized pilot study. Subjects were randomly assigned a number and treated with hyaluronic acid, divided between temporal and glabellar region, and abobotulinumtoxinA in the periorbital and glabellar region. A 1-month touch-up was given if needed. Subjects were evaluated by the investigator, and each subject completed a questionnaire at baseline and at 3, 6, and 9 months after treatment. For glabellar lines and crow's feet, median grades decreased from baseline at 1 month and at 3 months, but returned to baseline values at 6 months. For temporal assessments, the median grade decreased from baseline at 1, 3, and 6 months and returned to baseline at 9 months. Similar trends were observed in subjects' perceived age, perceived social and professional limitations, and desire to alter their facial appearance. Among subjects previously treated with botulinum toxin alone, 64% rated the combination treatment said "superior." Adverse effects were mild and transient. The combination of abobotulinumtoxinA and hyaluronic acid appears to rejuvenate the periorbital, temporal, glabellar, and crow's feet areas with minimal adverse effects.
authors.affiliation: Kenneth R Beer MD - General, Esthetic and Surgical Dermatology, West Palm Beach, FL, USA.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Beer
authors.forename: Hillary
authors.initials: H
authors.lastname: Julius
authors.forename: Monica
authors.initials: M
authors.lastname: Dunn
authors.forename: Fred
authors.initials: F
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D003357:Cosmetic Techniques; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005123:Eye; D005260:Female; D005546:Forehead; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D010865:Pilot Projects; D012060:Rejuvenation / Q000523:psychology; D012649:Self Concept; D015595:Skin Aging / Q000187:drug effects*; D011795:Surveys and Questionnaires
chemical_list: D003879:Dermatologic Agents; D009465:Neuromuscular Agents; D006820:Hyaluronic Acid; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA
keywords: abobotulinumtoxinA; filler; rejuvenation; upper face