Fine lines and wrinkles, loss of volume, texture changes, and solar lentigines around the mouth are the result of both extrinsic and intrinsic factors, and are common concerns seen in cosmetic practice. Perioral rejuvenation can be addressed using a variety of noninvasive means including botulinum toxin, fillers, and laser resurfacing. In clinical practice, a multifaceted treatment plan utilizing a variety of noninvasive means to address the multiple tissue changes is often undertaken. Combining botulinum toxin with fillers or laser resurfacing has previously been shown to produce more desirable and longer lasting results. Here we report the results of using a sequential approach with all three modalities.

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