Objectives: To assess the effectiveness of using exosomes and botulinum toxin type A for treating large facial pores, facial flushing, and skin pigmentation.

Introduction: Exosomes have recently received much attention for their effects on facial rejuvenation. The addition of exosomes to the intradermal injection of botulinum toxin was explored as a treatment protocol for skin conditions such as large skin pores, skin flushing, and skin pigmentation.

Materials / method: Subjects with large facial pores, medium to severe skin flushing and skin pigmentation were separately selected for this study. These subjects were treated using the following sequence. On day 1, the subjects were treated via air dissection and micro-droplet Botulinum Toxin type A. After one week, exosome was applied to the treatment area using a meso-roller. Two weeks later, another round of air dissection and micro-droplet BTXA injection was followed by the exosome application the following week. The subjects were followed up 3 weeks and 6 weeks after the first treatment.

Results: Visible improvements to pore size and depth, skin flushing, and skin pigmentation were first documented at 3 weeks after initial treatment. At 6 weeks after initial treatment, assessment using QuantifiCare 3D Lifeviz and Mark Vu facial skin analyzer showed a significant decrease in skin pores, improvement in skin flushing, and improvement in skin pigmentation.

Conclusion: In this study, the use of exosomes and Botulinum Toxin type A has been demonstrated to be an effective protocol for the treatment of large facial pores, facial flushing, and skin pigmentation.

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Objectives: This study shows holistic approach for tear trough and malar area correction in asian patients.

Introduction: In asians maxillary area usually tends to lack of projection. Therefore, tear trough deformity may also be more obvious already in younger patients. However, due to the anatomical characteristics, palpebromalar groove correction is less required. Holistic approach, based on a proper technique and ideal hyaluronic acid (HA) filler, is essential to obtain excellent results.

Materials / method: Tear trough was treated with a specific cross-linked and not cross-linked hyaluronic acid filler (15mg/ml) enriched with aminoacids and vitamins. Malar area volume restoration was performed combining 2 different HA fillers in 2 different layers: high G’ HA on the periosteum level and dynamic long chain HA filler in the deep malar fat pad. In major malar atrophy a third type of filler has been added in the superficial malar fat pad. Follow up and patient medical photography were performed. Aesthetic improvement was subjectively estimated by the authors. Patient satisfaction was assessed.

Results: The authors show tear trough and malar area treatment results in asian patients. Photographic and live assessments confirm general aesthetic improvement in facial volume and proportion restoration. The treatment has long lasting results. No severe adverse events were detected.

Conclusion: Tear trough combined with malar area HA filler injection is an effective and safe method for midface volume loss correction in Asians. This technique enhances facial volume leading to restore volume and proportions for a more attractive appearance.

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