Objectives: In patients with moderate to severe glabellar frown, the additional administration of hyaluronic acid filler to the BoNT-A type A injection had a considerable effect on the improvement of wrinkles and the subjects were also satisfied.
Combination therapy of BoNT-A and hyaluronic acid filler can be a safe and an effective treatment for moderate to severe glabellar frown.

Introduction: Among numerous cosmetic procedures for face rejuvenation performed all over the world, botulinum toxin type A (BoNT-A) for wrinkles is one of the most widely practiced procedures. However, for severe frowns, the application of botulinum toxin is often insufficient. In this study, the effects of hyaluronic acid filler combination therapy and the BoNT-A alone were evaluated.

Materials / method: Forty subjects with 2 or higher points (moderate to severe) of a facial wrinkle scale (FWS) when frowning in the glabellar area were assigned to 2 group: Botulinum toxin type A monotherapy group and a combination regimen of the toxin and hyaluronic acid filler group. Subjects visited outpatient department every 4 weeks until 28 weeks after the injection, and the assessment of the efficacy using FWS, subject satisfaction at both resting and maximum frowning and safety analysis were performed.

Results: Subjects of both group was administered 18U of BoNT-A and the subjects of the combination group received additional 0.45mL of hyaluronic acid filler regimen.
Both at rest and maximum frown, the combination group scored lower FWS than the toxin and showed significance in the week-20 and week-28. And at final visit, subject satisfaction score of the combination was higher than that of toxin group.

Conclusion: For patients with moderate to severe glabellar frown, the combined administration of BoNT-A and hyaluronic acid filler could be a considerable treatment for improving wrinkles.

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Objectives: There are various skin booster in the aesthetic fields and should understand between collagen synthesis and fibrosis. Skin booster injection is very much related to facial layers.

Introduction: There are various biostimulators in aesthetic market and the mechanism is related with fibroblast activation and macrophage modulation.

Materials / method: We will overview the proposed mechanism of biostimulators and facial layer relationship which dermal activation and subcutaneous reaction of foreign body reaction.

Results: Dermis is the key point for biostimulation and multiple injection methods are proposed for proper injection.
Subcutaneous injection are made by biostimulators and fibrosis study should be made.

Conclusion: Proper use of biostimulation is needed. Not all the mechanism are same for various biostimulations

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Objectives: The pursuit of natural-looking lip enhancement has gained significant attention, particularly among Asian patients who often prefer subtle, harmonious results. This study explores the combined use of lip fillers and thread lifting techniques to achieve a balanced and natural appearance. Lip fillers provide volume and hydration, while threads enhance definition and lift, addressing unique anatomical considerations in Asian lips. By leveraging the complementary benefits of both procedures, practitioners can achieve tailored outcomes that respect cultural aesthetics and individual prefer

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Objectives: To evaluate the efficacy of a multimodal treatment protocol—comprising microfocused ultrasound (MFU), dermal fillers, biostimulators, and botulinum toxin—in achieving comprehensive lip and perioral rejuvenation and beautification.

Introduction: Aging of the lips and perioral region is marked by the progressive loss of collagen, elastic fibers, hyaluronic acid, and subcutaneous fat. These changes diminish hydration, elasticity, and volume, leading to clinical manifestations such as perioral rhytides, lip thinning, oral commissure descent, and marionette lines. Modern beauty standards underscore the lips as a key feature of facial attractiveness, necessitating both rejuvenation and enhancement interventions.

Materials / method: A combination of microfocused ultrasound with visualization (MFU-V), hyaluronic acid dermal fillers, biostimulators (polynucleotides), and botulinum toxin was employed to target structural deficiencies of the perioral region. MFU-V was used to stimulate neocollagenesis. Dermal fillers restored volume, corrected asymmetries, and enhanced lip borders. Biostimulator promoted long-term collagen regeneration, while botulinum toxin addressed dynamic perioral lines. Representative clinical cases were analyzed to illustrate treatment outcomes.

Results: The multimodal approach resulted in significant improvement in perioral aging signs, including smoother perioral rhytides, restored lip volume, corrected asymmetries, elevated oral commissures, and softened marionette folds. Aesthetic enhancements produced fuller, more balanced, and well-defined lips, aligning with contemporary beauty ideals. Patient satisfaction was high, and treatments were well tolerated without major adverse events.

Conclusion: A multimodal strategy integrating MFU, dermal fillers, biostimulators, and botulinum toxin is effective for both perioral rejuvenation and aesthetic enhancement. This approach not only reverses signs of aging but also enhances lip morphology for improved facial attractiveness. These findings support the adoption of comprehensive treatment protocols tailored to individual patient needs.

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