A New Technique for the Correction of Tear Trough Deformity via Filler Injections

Abstract

Summary:The nonsurgical treatment of valley-type tear trough (TT) deformity with diffuse depression in preseptal segment aims a more effective and safer treatment alternative to present padding techniques through the use of hyaluronic acid fillers to the preseptal space. 22G 50-mm cannula was inserted into the preseptal space, 2 cm inferolateral to the lateral canthus, and a low concentration of monophasic hyaluronic acid filler was applied. TT deformity was treated through the elimination of the contrasting subcutaneous fat tissue quality and quantity both above and below the TT, which contributes to the accentuation of the TT deformity. Valley-type TT deformity was successfully treated without any complications via filler injections to the preseptal space in which no structures pass.

Hyaluronic acid for lower eyelid and tear trough rejuvenation: review of the literature

“…There were eighteen prospective studies [12][13][14][15][16][17][18][19][20][21] , twenty retrospective studies [22][23][24][25][26][27][28][29][30][31] , and one that was both retrospective and prospective [32] ; the study type was not mentioned in twenty-seven [33][34][35][36][37][38][39][40][41][42] .…”

“…Eight review articles have been written, the first in 2007 [33] , then in 2010 [36] , 2012 [38][39][40] and from 2016 to 2020 [44][45][46][47] , and two comparative studies were published in 2006 [13,22] . Twenty-nine papers are case-series [11,18,[27][28][29][48][49][50][51][52] , thirteen are case-reports [20,30,31,37,39,[53][54][55][56][57] whilst the remainder [26,34,35,40,[58][59][60][61][62][63][64][65][66] are related to general content [ Figure 1].…”

“…Anaesthesia has been used both by local infiltration [11,19,24,31] or by topical application [13][14][15][16][17]48,52] .…”

“…Injections performed by needle have been described since 2005 up to 2019 [11][12][13][14][15][16]21,28,33,74] , while cannula use has been reported since 2017 [19,30,31,52,71] and only two studies reported both techniques [17,62] .…”

“…The injection depth is reported to be carried out directly at the orbital bony border [11,13,15,16,19,27,48,71,73,74] , either under the orbicularis oculi muscle [14,24,31,32,50,66,71,74] or subcutaneously [12,33] . The average amount of HA injected into each side is 0.56 mL and ranges from 0.2 mL [12] to 2.0 mL [44] .…”