摘要

Objectives: To demonstrate that periocular rejuvenation requires a global, anatomically driven approach addressing multiple facial compartments. To highlight how structural rebalancing using botulinum toxin and hyaluronic acid may restore periocular harmony and symmetry in patients with persistent concerns following prior surgical intervention. Introduction: The periocular region plays a central role in facial aging and expression. Patients previously treated with isolated techniques may experience suboptimal outcomes due to lack of structural integration. A comprehensive approach addressing upper, middle, and lateral facial compartments may improve global aesthetic harmony. Materials / method: A female patient with prior upper blepharoplasty and persistent asymmetry and tired appearance underwent a multimodal treatment approach. IncobotulinumtoxinA was administered to the upper third. Two cohesive polydensified matrix hyaluronic acid fillers were used to restore structural support and modulate vector dynamics in the temporal fossa, supraorbital hollow, zygomatic region, and infraorbital area. Outcomes were evaluated using standardized photography, VECTRA H2 imaging technology, and the Global Aesthetic Improvement Scale (GAIS) at baseline and 90-day follow-up. Results: At follow-up on days 30, 60, and 90, the patient showed improvement according to the GAIS assessment. Three-dimensional analysis using VECTRA H2 imaging revealed changes consistent with improved contour integration in the periocular and midfacial regions. Adverse events included mild hematomas and edema, which resolved spontaneously within 30 days without intervention. Conclusion: In this case, a multimodal approach addressing multiple facial compartments was associated with improved periocular appearance and symmetry following prior surgical intervention. Strategies focused on structural support and vector modulation may contribute to more integrated aesthetic outcomes in selected patients.