Combined Non-Surgical Therapy for Facial Rejuvenation with “Botulinum Toxin Type A” and Injectable Fillers

Non-surgical treatment of facial aging can be described from various perspectives by the nature of the deformity, by the skin layer in which the pathology occurs, or by the technique used to address it. Because of the many causes of rhytids, in as much as various anatomic locations that respond differently to treatment and over time the effects of aging coincide and overlap and so, the optimal treatment often necessitates a multifaceted approach. It is believed that when Botulinum toxin type-A (BTX-A) is used in combination with hyaluronic acid fillers in the appropriate patient in the same region, it reduces the muscular movement of the face, which allows for greater tissue residence of the filler and restoration of the balance of facial movement and position. Aim: The aim of this study was to review and describe our experience with combination therapy for facial skin rejuvenation using butulinum toxin type-A (BTX-A) injections with dermal fillers most commonly used in our practice, namely hyaluronic acid derivatives (Restylane, Juviderm), Polyacrylamide hydrogel (Esteform), or combination (Amazingel).