Office-based periorbital rejuvenation.

Periorbital aging involves changes that are multidimensional and multifactorial. Previous discussions have focused on soft tissue changes. Recent literature, however, has shown that changes occur in the bony structure surrounding the eye, which causes a substantial impact upon the aging process especially with respect to volumetric changes. Comprehensive analysis of both soft tissue and bony structural changes are essential. One procedure or technique alone is usually insufficient. Surgical procedures address some aspects of aging but leave many elements untreated. Office-based nonsurgical procedures form an important basis for periorbital rejuvenation including cosmeceuticals, chemical peels, laser and light treatments, neurotoxins, and fillers. Improved understanding of the pathophysiology of aging and technical advancements in nonsurgical techniques has enabled us to achieve better and more comprehensive improvement for our patients.