Repeated Full-Face Aesthetic Combination Treatment With AbobotulinumtoxinA, Hyaluronic Acid Filler, and Skin-Boosting Hyaluronic Acid After Monotherapy With AbobotulinumtoxinA or Hyaluronic Acid Filler

Dermatol Surg. 2020 Apr;46(4):475-482. doi: 10.1097/DSS.0000000000002165.


Background: Full-face aesthetic treatment involving several treatment modalities may improve facial aesthetic outcome.

Objective: To evaluate clinical outcomes and patient perceptions of monotherapy with either abobotulinumtoxinA (ABO) or hyaluronic acid (HA) filler followed by full-face combination treatments of ABO, HA filler, and skin-boosting HA (RSB).

Materials and methods: Subjects aged 35 to 50 years were randomized to monotherapy with 50 s.U ABO in the glabella or ≤1 mL HA filler in the nasolabial folds (NLFs)/cheeks. At Month 6 and Month 12, all subjects received combination treatment with ≤50 s.U ABO in the glabella, ≤2 mL HA filler in the NLFs/cheeks (and other facial areas as applicable), and ≤1 mL RSB (additional RSB treatment at Month 7). Assessments included global facial aesthetic appearance and improvement, first impression, perceived age, wrinkle severity, satisfaction questionnaires, and adverse events.

Results: Repeated full-face combination treatment with ABO, HA filler, and RSB was associated with considerably higher levels of aesthetic improvement and subject satisfaction than monotherapy with ABO or HA filler. Improvement rate of glabellar lines was increasing with each treatment.

Conclusion: Repeated combination treatment achieved greater change in global facial aesthetic appearance than monotherapy. Aesthetic improvement and subject satisfaction was high and increased with each treatment. All treatments were well tolerated.

Publication types

  • Clinical Trial, Phase IV
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcholine Release Inhibitors / administration & dosage*
  • Adult
  • Botulinum Toxins, Type A / administration & dosage*
  • Combined Modality Therapy / methods
  • Cosmetic Techniques*
  • Dermal Fillers / administration & dosage*
  • Esthetics
  • Face
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage
  • Hyaluronic Acid / analogs & derivatives*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Rejuvenation
  • Retreatment / methods
  • Skin Aging
  • Treatment Outcome


  • Acetylcholine Release Inhibitors
  • Dermal Fillers
  • Hyaluronic Acid
  • Botulinum Toxins, Type A
  • abobotulinumtoxinA
  • Restylane