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Facial aesthetics and rejuvenation techniques have been evolving, with the most commonly applied techniques being the use of hyaluronic acid fillers and botulinum neurotoxins. Because of complementary actions, it is common for both products to be used in the same anatomical sites to optimize outcomes, either administered consecutively at one visit or at two separate visits. The author shows for the first time that hyaluronic acid (HA) and botulinum neurotoxin (BNT) can be delivered in combination in the same syringe — at the same time — to rejuvenate the upper face. Not only does concomitant administration result in excellent clinical outcome, without apparently compromising the attributes of either product alone, but this technique enhances the patient experience by allowing the use of small-gauge needles and inherently decreasing, by half or more, the number of needle sticks incurred. Larger studies are underway to study optimal techniques for administering HA and BNT combined in a single syringe.

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