Effectiveness and safety of combination of microneeding with microneeding and mesotherapy in periorbital rejuvenation: A split face, prospective and controlled study

Early signs of facial aging usually first appear around the eyes. Clinical symptoms include dynamic and static wrinkles, hyperpigmentation, loss of elasticity and enlargement of pores. With advances in cosmetic medicine, minimally invasive procedures have become first-line treatment options in periorbital rejuvenation. Microneedling method and mesotherapy are among these options. The aim of this prospective, controlled, single-center study is to evaluate with objective measurements whether mesotherapy provides a synergistic effect on the remodeling cascade we provided with Percutaneous Collagen Induction Therapy by applying microneedling alone or in combination with mesotherapy in the split face model in periorbital rejuvenation. The study included 35 healthy female volunteers who admitted to Uludag University Medical Faculty Dermatocosmetology Polyclinic between November 2021 and February 2022. A combination of microneedling and mesotherapy was applied to the right eye region, and only microneedling treatment was applied to the left eye region. The periorbital region of each subject was photographed with Antera 3D ® for comparison with post-treatment measurements. The measurements taken before the treatment, at the 2nd month of the treatment (at application for the 4th session, after the first 3 induction sessions) and 3 weeks after the end of treatment were recorded. Parameters to be evaluated; wrinkle depth, periorbital pigmentation, smoothness of skin tissue and pore width were determined. At the end of the treatment, pain vii intensity was scored with a visual analog scale (scaled between 0-10) to evaluate the tolerance of the volunteers, and a 4-parameter volunteer satisfaction questionnaire was conducted to evaluate the volunteer satisfaction. According to the analysis of the data we obtained, a statistically significant change was obtained in the overall size and depth of wrinkles over time, in the right eye region treated with the combination treatment, compared to the left eye region. In the measurement of wrinkle width and melanin variation, a statistically significant change was obtained in the left eye region compared to the right eye region over time. With the treatment applied, statistically significant changes were obtained in the measurement of pore number, pore volume, skin roughness, melanin relative variation, melanin mean level, hemoglobin variation and relative variation in both periorbital regions, however, when the changes we obtained were compared, it was determined that there was no statistically significant difference in the change in the right eye region compared to the left eye region. The presence of a statistically significant difference with the treatment in both periorbital regions, but no statistically significant additional benefit other than the total wrinkle size and depth parameters on the side where mesotherapy was applied, supports the effectiveness of microneedling and supports the contradictory results that we have seen in the literature data on the effectiveness of mesotherapy with objective measurements.