title: Rejuvenation of the Upper Face and Periocular Region: Combining Neuromodulator, Facial Filler, Laser, Light, and Energy-Based Therapies for Optimal Results.
abstract: BACKGROUND
  The upper face and periocular region is a complex and dynamic part of the face. Successful rejuvenation requires a combination of minimally invasive modalities to fill dents and hollows, resurface rhytides, improve pigmentation, and smooth the mimetic muscles of the face without masking facial expression.
  
  
  METHODS
  Using review of the literature and clinical experience, the authors discuss our strategy for combining botulinum toxin, facial filler, ablative laser, intense pulsed light, microfocused ultrasound, and microneedle fractional radiofrequency to treat aesthetic problems of the upper face including brow ptosis, temple volume loss, A-frame deformity of the superior sulcus, and superficial and deep rhytides.
  
  
  RESULTS
  With attention to safety recommendations, injectable, light, laser, and energy-based treatments can be safely combined in experienced hands to provide enhanced outcomes in the rejuvenation of the upper face.
  
  
  CONCLUSIONS
  Providing multiple treatments in 1 session improves patient satisfaction by producing greater improvements in a shorter amount of time and with less overall downtime than would be necessary with multiple office visits.
authors.affiliation: *Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina; †Department of Dermatology & Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Departments of ‡Ophthalmology, and §Dermatology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Nicole
authors.initials: N
authors.lastname: Langelier
authors.forename: Katie
authors.initials: K
authors.lastname: Beleznay
authors.forename: Julie
authors.initials: J
authors.lastname: Woodward
mesh_terms: D001763:Blepharoptosis / Q000628:therapy*; D001905:Botulinum Toxins / Q000627:therapeutic use; D003131:Combined Modality Therapy; D000067548:Dermal Fillers / Q000627:therapeutic use; D005123:Eye; D005546:Forehead; D006801:Humans; D062325:Intense Pulsed Light Therapy; D053685:Laser Therapy; D009339:Needles; D000078702:Radiofrequency Therapy; D012060:Rejuvenation; D015361:Rhytidoplasty; D015595:Skin Aging; D014464:Ultrasonic Therapy
chemical_list: D000067548:Dermal Fillers; D001905:Botulinum Toxins