Periocular rejuvenation: current concepts and evidence-based management
- 1Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
- 2Department of Sense Organs, Sapienza University of Rome, Rome, Italy
Abstract
The periocular region shows early visible ageing because thin skin, repetitive orbicularis oculi activity, retaining ligaments, orbital fat, and the bony framework change together. Clinical manifestations include rhytids, dermatochalasis, eyelid laxity, tear trough deformity, edema, and dark circles, with potential cosmetic, ocular-surface, and functional consequences. Assessment should distinguish pigmentary, vascular, structural, and volume-related findings and should include eyelid position and laxity, brow position, ocular-surface status, relevant medication use, and visual-field testing when functional symptoms are present. Management is anatomy driven. Botulinum toxin type A, hyaluronic acid fillers, light- and energy-based procedures, and selected regenerative or collagen-biostimulatory injectables may benefit appropriately selected patients, whereas blepharoplasty and fat repositioning remain the reference treatments for substantial tissue laxity, fat prolapse, or functional impairment. Evidence is strongest for established indications but remains heterogeneous across devices, injection techniques, and emerging products. Early positive clinical, objective, mechanistic, and safety data for polynucleotides and collagen biostimulators indicate insufficient evidence to determine comparative efficacy rather than evidence of absent effect. Procedure-specific recommendations should therefore be interpreted according to whether they arise from comparative studies, consensus, anatomical principles, or expert practice.
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BibTeX
@article{martucci2026periocular,
title = {{Periocular rejuvenation: current concepts and evidence-based management}},
author = {Alessio Martucci and Flavia Quaranta Leoni and Matteo Di Marino and Enrico Romano},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1943441},
url = {https://doi.org/10.3389/fmed.2026.1943441},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Periocular rejuvenation: current concepts and evidence-based management
AU - Alessio Martucci
AU - Flavia Quaranta Leoni
AU - Matteo Di Marino
AU - Enrico Romano
PY - 2026
DA - 2026/10/12
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1943441
UR - https://doi.org/10.3389/fmed.2026.1943441
AB - The periocular region shows early visible ageing because thin skin, repetitive orbicularis oculi activity, retaining ligaments, orbital fat, and the bony framework change together. Clinical manifestations include rhytids, dermatochalasis, eyelid laxity, tear trough deformity, edema, and dark circles, with potential cosmetic, ocular-surface, and functional consequences. Assessment should distinguish pigmentary, vascular, structural, and volume-related findings and should include eyelid position and laxity, brow position, ocular-surface status, relevant medication use, and visual-field testing when functional symptoms are present. Management is anatomy driven. Botulinum toxin type A, hyaluronic acid fillers, light- and energy-based procedures, and selected regenerative or collagen-biostimulatory injectables may benefit appropriately selected patients, whereas blepharoplasty and fat repositioning remain the reference treatments for substantial tissue laxity, fat prolapse, or functional impairment. Evidence is strongest for established indications but remains heterogeneous across devices, injection techniques, and emerging products. Early positive clinical, objective, mechanistic, and safety data for polynucleotides and collagen biostimulators indicate insufficient evidence to determine comparative efficacy rather than evidence of absent effect. Procedure-specific recommendations should therefore be interpreted according to whether they arise from comparative studies, consensus, anatomical principles, or expert practice.
SN - 2296-858X
ER -