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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Pharmateca</journal-id><journal-title-group><journal-title xml:lang="en">Pharmateca</journal-title><trans-title-group xml:lang="ru"><trans-title>Фарматека</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2073-4034</issn><issn publication-format="electronic">2414-9128</issn><publisher><publisher-name xml:lang="en">Bionika Media</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">380904</article-id><article-id pub-id-type="doi">10.18565/pharmateca.2025.10.87-91</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Protocol for correcting age-related changes in the periorbital region</article-title><trans-title-group xml:lang="ru"><trans-title>Протокол коррекции возрастных изменений периорбитальной области</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2249-5441</contrib-id><name-alternatives><name xml:lang="en"><surname>Kruglik</surname><given-names>Ekaterina V.</given-names></name><name xml:lang="ru"><surname>Круглик</surname><given-names>Екатерина Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ekaterinakruglik@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1866-1993</contrib-id><name-alternatives><name xml:lang="en"><surname>Kruglik</surname><given-names>Sergey V.</given-names></name><name xml:lang="ru"><surname>Круглик</surname><given-names>Сергей Викторович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ekaterinakruglik@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">VIP Clinic, Network of Plastic Surgery and Cosmetology Clinics</institution></aff><aff><institution xml:lang="ru">Сеть клиник пластической хирургии и косметологии VIP clinic</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Institute of Plastic Surgery and Cosmetology, Moscow Healthcare Department</institution></aff><aff><institution xml:lang="ru">Институт пластической хирургии и косметологии ДЗМ</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-12-31" publication-format="electronic"><day>31</day><month>12</month><year>2025</year></pub-date><volume>32</volume><issue>10</issue><fpage>87</fpage><lpage>91</lpage><history><date date-type="received" iso-8601-date="2026-02-03"><day>03</day><month>02</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Bionika Media</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, ООО «Бионика Медиа»</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Bionika Media</copyright-holder><copyright-holder xml:lang="ru">ООО «Бионика Медиа»</copyright-holder></permissions><self-uri xlink:href="https://journals.rcsi.science/2073-4034/article/view/380904">https://journals.rcsi.science/2073-4034/article/view/380904</self-uri><abstract xml:lang="en"><p><bold>Background: </bold>Premature aging of the periorbital region, characterized by bone resorption, changes in fat pads, thinning skin, and the formation of «malar bags,» presents a complex aesthetic problem. Surgical methods, due to their high invasiveness and lengthy rehabilitation, often have limited popularity among patients.</p> <p><bold>Objective:</bold> Development and evaluation of the effectiveness of a three-stage non-invasive protocol for periorbital rejuvenation aimed at reducing the rehabilitation period and achieving a pronounced aesthetic result.</p> <p><bold>Materials and methods: </bold>The study included 32 female patients aged 28–35 years. The single-stage protocol included: 1) high-intensity focused ultrasound (HIFU) treatment of the infraorbital fat pad for compaction; 2) deep microbolus injection of a hyaluronic acid-based filler (24 mg/ml) along the ligaments for volumization; 3) microneedle radiofrequency (RF) lifting for skin remodeling. Efficacy was assessed by photographic documentation and patient questionnaires after 30 days using a numerical rating scale (NRS, 0-5 points).</p> <p><bold>Results: </bold>One month after the procedure, a visible reduction in the appearance of «malar bags» and an improvement in skin condition were noted. The average patient satisfaction rating on the NRS was 4.2 points («the result exceeds expectations»). None of the participants rated the result as unsatisfactory (1–2 points). Side effects were minimal, and the recovery period was short. Conclusion: The proposed combined protocol, targeting various layers and structures (subcutaneous fat, deep volumes, skin), is a highly effective, safe, and well-tolerated alternative to surgery for the correction of age-related changes in the periorbital region, including malar bags.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование: </bold>Раннее старение периорбитальной области, проявляющееся резорбцией костной ткани, изменениями жировых пакетов, истончением кожи и формированием «малярных мешков», представляет сложную эстетическую проблему. Хирургические методы, обладая высокой травматичностью и длительной реабилитацией, часто имеют ограниченную популярность у пациентов.</p> <p><bold>Цель исследования:</bold> разработать и оценить эффективность трехступенчатого неинвазивного протокола омоложения периорбитальной области, направленного на сокращение периода реабилитации и достижение выраженного эстетического результата.</p> <p><bold>Материалы и методы: </bold>В исследование включены 32 пациентки в возрасте 28–35 лет. Одномоментный протокол включал: 1) воздействие высокоинтенсивным сфокусированным ультразвуком (HIFU) на подглазничную жировую клетчатку для ее компактизации; 2) глубокое микроболюсное введение филлера на основе гиалуроновой кислоты (24 мг/мл) по ходу связок для волюмизации; 3) микроигольчатый радиочастотный лифтинг (RF) для ремоделирования кожи. Оценка эффективности проводилась путем фотофиксации и анкетирования пациентов через 30 дней по цифровой рейтинговой шкале (NRS, 0–5 баллов).</p> <p><bold>Результаты: </bold>Через месяц после процедуры отмечено видимое уменьшение выраженности «малярных мешков» и улучшение состояния кожи. Средняя оценка удовлетворенности пациенток по шкале NRS составила 4,2 балла («результат превосходит ожидания»). Ни одна из участниц не оценила результат как неудовлетворительный (1–2 балла). Побочные эффекты были минимальны, период восстановления — коротким.</p> <p><bold>Заключение: </bold>Предложенный комбинированный протокол, воздействующий на различные слои и структуры (подкожно-жировую клетчатку, глубокие объемы, кожу), является высокоэффективной, безопасной и хорошо переносимой альтернативой хирургическому вмешательству для коррекции возрастных изменений периорбитальной области, включая «малярные мешки».</p></trans-abstract><kwd-group xml:lang="en"><kwd>HIFU</kwd><kwd>aging</kwd><kwd>rejuvenation</kwd><kwd>periorbital region</kwd><kwd>radiofrequency microneedling</kwd><kwd>filler</kwd><kwd>molar bags</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>HIFU</kwd><kwd>старение</kwd><kwd>омоложение</kwd><kwd>периорбитальная область</kwd><kwd>радиочастотный микроигольчатый лифтинг</kwd><kwd>филлер</kwd><kwd>малярные мешки</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Franco A.C., Aveleira C., Cavadas C. 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