Protocol for correcting age-related changes in the periorbital region

Background: Premature aging of the periorbital region, characterized by bone resorption, changes in fat pads, thinning skin, and the formation of «malar bags,» presents a complex aesthetic problem. Surgical methods, due to their high invasiveness and lengthy rehabilitation, often have limited popularity among patients.

Objective: Development and evaluation of the effectiveness of a three-stage non-invasive protocol for periorbital rejuvenation aimed at reducing the rehabilitation period and achieving a pronounced aesthetic result.

Materials and methods: The study included 32 female patients aged 28–35 years. The single-stage protocol included: 1) high-intensity focused ultrasound (HIFU) treatment of the infraorbital fat pad for compaction; 2) deep microbolus injection of a hyaluronic acid-based filler (24 mg/ml) along the ligaments for volumization; 3) microneedle radiofrequency (RF) lifting for skin remodeling. Efficacy was assessed by photographic documentation and patient questionnaires after 30 days using a numerical rating scale (NRS, 0-5 points).

Results: One month after the procedure, a visible reduction in the appearance of «malar bags» and an improvement in skin condition were noted. The average patient satisfaction rating on the NRS was 4.2 points («the result exceeds expectations»). None of the participants rated the result as unsatisfactory (1–2 points). Side effects were minimal, and the recovery period was short. Conclusion: The proposed combined protocol, targeting various layers and structures (subcutaneous fat, deep volumes, skin), is a highly effective, safe, and well-tolerated alternative to surgery for the correction of age-related changes in the periorbital region, including malar bags.