Conclusions

Total global nonsurgical restoration employs the three “R”s—resurfacing, relaxation, and refilling. Resurfacing employs nonablative, fractional nonablative, fractional ablative,

and ablative modalities. The nature of the device to be employed for resurfacing depends on the extent of anomalies of the facial canvas. Relaxation employs botulinum toxin A on both the upper and lower face. Refilling employs dermal fillers, sometimes used in combi­nation with each other. While monotherapy of all these modalities show impressive clinical outcomes, the best patient satisfaction is achieved when these modalities are used in com­bination, as they each address anomalies in a complementary fashion. The trend in device­based rejuvenation is to employ devices which produce clinically significant results with reduction in recovery and side effects. Hence, photorejuvenation and fractional resurfacing predominate devices for the facial canvas. The trend in dermal fillers is to enhance longev­ity and address global volume loss, often requiring different classes of dermal fillers used in combination to accomplish these goals. The trend in botulinum toxins complement these therapies by addressing dynamic rhytids in a global fashion. Therefore, with the com­bination of devices, fillers, and botulinum toxins, total nonsurgical restoration can be accomplished.