Correction of tear trough deformity by hyaluronic acid soft tissue filler placement inferior to the lateral orbital thickening

Abstract

Tear trough deformities can be a sign of facial aging and exert a negative impact in facial attractiveness. Surgical techniques and adipose tissue transfer have been used to improve tear trough deformity. In recent years, minimal invasive procedures such as soft tissue filler injections became more popular. We report a retrospective evaluation of 45 Caucasian female patients ≥40 years (mean age of [58.8 ± 8.9] years). Severity of tear trough was classified according to Hirmand: 3 as grade I, 28 as grade II, and 14 grade III tear trough deformities. We used a monophasic hyaluronic acid, low G prime filler placed inferior to the lateral orbital thickening. On average, 0.4 ml of hyaluronic acid (HA) filler were injected per side. The improvement was I grade 29 patients and II grades in 16 patients. The improvement lasted (10.8 ± 2.3) months. No severe adverse events were noted. Vascular danger zones can be avoided.

Rheologic and Physicochemical Characteristics of Hyaluronic Acid Fillers: Overview and Relationship to Product Performance

“…In areas of the upper face where filling and volume restoration are required, as in the temporal fossa, 14 38 39 40 41 the HA filler should have high elasticity or resistance to deformation (G′) and medium to high cohesivity. To address forehead contour, the filler chosen should have a medium to high G′ and a low to medium cohesivity, 42 which would allow for molding and some degree of spread upon injection.…”

A novel hybrid BonT‐A and hyaluronic acid cannula‐based technique for eyelid ptosis and periorbital rejuvenation

“…In this setting, the choice of IncoBonTA relies on its stable safety profile, and lower risk of neutralizing antibodies with predictable spread, while delivering a high degree of efficacy. [21][22][23] For the periorbital area, since the effect of the BonTA is transient, the addition of an HA with optimal tissue integration for intradermal injection improves the treatment of the periorbital fine wrinkles, 24 aiming for long-term results, since HAB has been shown to improve skin quality and firmness. 25…”

“…For the periorbital area, since the effect of the BonTA is transient, the addition of an HA with optimal tissue integration for intradermal injection improves the treatment of the periorbital fine wrinkles, 24 aiming for long‐term results, since HAB has been shown to improve skin quality and firmness 25…”

Fat or fillers: The dilemma in eyelid surgery

“…Wollina and Goldman[ 52 ] chose a HA filler with high viscosity and cohesivity to be placed above the periosteum to treat tear-trough deformity and the palpebro-malar groove. They selected a single injection point inferior to the lateral orbital thickening so as to avoid Tyndall effect and vascular danger zones.…”