The periocular region is the focal point of facial communication. Millimetre increments of change required to achieve bilateral symmetry and harmony can be difficult to achieve by surgical means only. Non-surgical aesthetic modifications offer a number of advantages in selected cases compared with traditional surgical methods. The author of this article evaluates aspects of periocular aesthetics by two-dimensional frontal plane considerations or by three-dimensional considerations, in which the Z-coordinate is correlated to volumetric changes. Aesthetic parameters viewed in the two-dimensional plane are the margin reflex distance (MRD1, MRD2), scleral show, tarsal platform show and brow fat span. The latter both also being highly interpreted as 3-D parameters due to their dependence upon on supratarsal volume. Mancini defines the lower eyelid and the midface to be the most sensitive perioculars subcomplex to three-dimensional volumetric changes. The author continues with a concise description of non-surgical procedures (based on botulinum toxin A and hyaluronic acid) to manage the eyebrow region, the upper lid and the lower lid. This article offers a spectrum of non-surgical modalities in the form of hyaluronic acid and botulinum toxin A.

Nonsurgical considerations for addressing periocular aesthetics – A conceptual dimensional approach.
Mancini R.
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Gregor M Bran

Dr Horst Schmidt Kliniken, Wiesbaden, Germany.

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