Zeitschrift für klinische und experimentelle Dermatologieforschung
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Hyaluronic Acid Associated with Abobotulinumtoxin Use along the Lower Periorbital Area: A Prospective Study

Denis Souto Valente, Rafaela Koehler Zanella and Sibelie Souto Valente

Objective: The aim of this study was to describe the superficial layer technique for filling the lower periocular area (LPOA) using injectable Hyaluronic Acid (HA) associated with Botulinum Toxin (BTX) injections on the same procedure, as well as presents its safety and effectiveness.
Methods: HA was applied above the orbital muscle starting from the infraorbital edge at the tear groove region going cranially to the edge of the lower eyelid with slow and steady movements. Then 45 Speywood Units of the BTX solution was injected in three equally divided doses along the lateral orbital rim in each side, The evaluation was performed by two independent physicians comparing before and 2 months post-procedure pictures giving scores ranging from none improvement (0) to maximum improvement (100). The intervention results were also measured by patients along the 2 months revision with a visual analogue scale using a 10 cm ruler where the score was determined by calculating the distance in mm from 0 to the patient's mark along the 10 cm line between the "none improvement" and the "maximum improvement" anchors providing scores from 0 to 100.
Results: 42 individuals entered the study. The evaluation conducted by the independent physicians showed an 84.1% improvement mean. Regarding patient satisfaction 0% found no improvement, 4.8% mild improvement, 26.3% moderate improvement, 64.1% great improvement and 4.8% maximum improvement after the procedure.
Conclusion: The AH and BTX use along the LPOA has proven to be a safe procedure. Therefore our data suggest that this technique is easy to perform, presents low risk of complications and provides a high degree of satisfaction among patients and independent evaluators.