Improved Periorbital Satisfaction After Combined Mid and Upper Facial Treatment With Hyaluronic Acid Fillers and OnabotulinumtoxinA: Effectiveness and Safety Results From a Post‐Marketing Study

ABSTRACT Background The periorbital region is among the first areas noticed in an individual, playing a crucial role in facial attractiveness and emotional expression. Aims Open‐label study to evaluate the impact of mid and upper facial treatment with hyaluronic acid (HA) fillers and onabotulinumtoxinA (onabotA) on periorbital satisfaction and appearance. Patients/Methods Eligible participants received ≥ 2 HA fillers (VYC‐15L, VYC‐17.5L, VYC‐20L) in the mid and upper face on Day 1, and VYC‐15L in the infraorbital hollow (IOH) on Day 30 if needed. Optional touch ups followed after 14 days. OnabotA was administered to glabellar lines (GL) and/or lateral canthal lines (LCL) on Day 60. The primary endpoint was the change from baseline in FACE‐Q Satisfaction with Eyes to Day 90. Additional effectiveness assessments and safety were monitored throughout. Results Enrolled participants were 86.3% White and 13.7% Asian. FACE‐Q Rasch‐transformed scores increased from baseline to Day 90 by 55.5 points ( p < 0.0001). Investigator‐assessed infraorbital appearance improved in 69.4% of participants at Day 30 ( p = 0.063 vs. baseline) and in 100% at Day 90. Periorbital appearance improved in 91.7% (investigator) and 95.8% (participant) of participants at Day 30, reaching 100% for both at Day 90 (nominal p < 0.0001 vs. baseline). IOH severity gradually decreased, with 59.8% of participants showing minimal or no severity at Day 90 versus 0% at baseline, and infraorbital volume increased. No unexpected safety signals were observed. Conclusions Combination of HA fillers and onabotA treatments improved eye satisfaction, periorbital and infraorbital appearance, IOH severity, and infraorbital volume, demonstrating direct and indirect treatment effects.