Neves, Maria Luiza Boechat BorgesThome, CeciliaSilva Junior, Silvio Ventura daMachado, ThalitaSánchez-Ayala, AlfonsoCâmara-Souza, Mariana BarbosaCanales, Giancarlo De la Torre2026-05-072026-05-072025-08M. L. B. B. Neves, C.Thome, S. V. da Silva Junior, et al., “Efficacy and Durability of the Association of Botox and Skinvive in the Treatment of Moderate/Severe Wrinkles in the Periorbital Region: A Randomized, Controlled, Double-Blind, Split-Face Clinical Study,” Journal of Cosmetic Dermatology, 24, no. 8 (2025): e70403, https://doi.org/10.1111/jocd.704031473-2165http://hdl.handle.net/10400.26/63016Background: The combined efficacy and durability of botulinum toxin A (BTX) and hyaluronic acid fillers (HA) for canthal wrinkles have not been thoroughly evaluated in randomized clinical trials. Aims: This study evaluated the efficacy, safety, and durability of the combined treatment protocol of onabotulinumtoxinA and Juvederm Volite VYC-12 (Skinvive) for moderate and severe canthal lines. Methods: This randomized double-blinded split-face trial included 25 women with periorbital dynamic wrinkles at severity levels II–IV according to the Merz 5-point scale. After bilateral onabotulinummtoxinA injections, the sides of the participants' faces were randomized to receive HA injections or a simulated injection. Assessed variables included electromyography activity (EMG), Merz 5-point crow's feet scale, and FACE-Q appraisal on crow's feet lines. Assessments were performed at baseline, 1, 2, 3, and 6 months. For differences in EMG and satisfaction scores, the two-way repeated measures ANOVA and Bonferroni's post hoc analyses were conducted. Wrinkle severity scores were analyzed with the Mann–Whitney U test. Results: Inter-treatment comparisons revealed no significant differences between treatment protocols in all assessed periods for EMG (p = 0.86). For severity of canthal wrinkles, onabotulinumtoxinA + VYC-12 exhibited lower canthal wrinkle severity in rest and contracted positions after 3 (p = 0.04), and 3 (p = 0.007) and 6 (p = 0.001) months, respectively. Additionally, satisfaction with BTX-HA treatment was significantly higher after 3-month (p = 0.001) and 6-month (p = 0.001) follow-ups compared to BTX treatment. Conclusions: Higher improvements in canthal wrinkles could be enhanced by using onabotulinumtoxinA and VYC-12 in association as a treatment protocol.engbotulinum toxin type aCanthal wrinkleshyaluronic acid filleronabotulinumtoxinAVYC-12contribution to journal10.1111/jocd.70403