Superficial technique for tear trough filling with cohesive polydensified matrix hyaluronic acid
Introduction: Deep tear troughs create unaesthetic hollows that often worsen the color alteration and aspect of dark undereye circles, thus giving an aged and tired appearance to the eyes, even in younger individuals. The use of dermal fillers for the restoration of volume loss in the area, with a wide variety of products and techniques, has been the most suitable treatment. Aim: Description and evaluation of the superficial intradermal injection technique for tear trough filling using cohesive polydensified matrix hyaluronic acid. Materials and Methods: 120 patients from Faculdade de Medicina do ABC’s Cosmetic Dermatology Sector and a private practice treated between the years 2011 and 2016. Results: All the patients rated the treatment result as good or very good. No important or long-lasting adverse effects were reported; the Tyndall effect was not observed either. Conclusion: The superficial technique is an easy and safe method to treat the tear trough deformity, with high rates of good aesthetic results.
2. Stutman RL, Codner MA. Tear trough deformity: review of anatomy and treatment options. Aesthet Surg J. 2012; 32: 426-440.
3. Wong CH, Hsieh MKH, Mendelson B. The tear trough ligament: anatomical basis for the tear trogh deformity. Plast Reconstr Surg. 2012; 129: 1392-1402.
4. Haddock NT, Saadeh PB, Boutros S, Thorne CH. The tear trough and lid/cheek junction: anatomy and implications for surgical correction. Plast Reconstr Surg. 2009; 123(4): 1332-1340.
5. Hirmand H. Anatomy and nonsurgical correction of the tear trough deformity. Plast Reconstr Surg. 2010; 125(2): 699-708.
6. Kane MAC. Treatment of tear troug deformity and lower lid bowing with injectable hyaluronic acid. Aesth Plast Surg. 2005; 29: 363-367.
7. Goldberg RA, Fiaschetti D. Filling the periorbital hollows with hyaluronic acid gel: initial experience with 244 injections. Ophthal Plast Reconstr Surg. 2006; 22(5): 335-341; discussion 341-343.
8. Braz AV, Aquino AO. Preenchimento do sulco nasojugal e da depressão infraorbital lateral com microcânula 30G. Surg Cosmet Dermatol. 2012; 4(2): 178-181.
9. Steinsapir KD, Steinsapir SMG. Deep-fill hyaluronic acid for the temporary treatment of the naso-jugal groove: a report of 303 consecutive treatments. Ophthal Plast Reconstr Surg. 2005; 22(5): 344-348.
10. Bosniak S, Sadick NS, Cantisano-Zikha M, Glavas IP, Roy D. The hyaluronic acid push technique for the nasojugal groove. Dermatol Surg. 2008; 34: 127-131.
11. Lim HK. Rejuvenation effects of hyaluronic acid injection on nasojugal groove: prospective randomized split face clinical controlled study. J Cosmet Laser Ther. 2014; 16(1): 32-36.
12. Mustak H, Fiaschetti D, Goldberg RA. Filling the periorbital hollows with hyaluronic acid gel: Long-term review of outcomes and complications. J Cosmet Dermatol. 2018; 17(4): 611-616.
13. Micheels P. et al. A blanching technique for intradermal injection of the hyaluronic acid belotero. Plast Reconst Surg. 2013; 132(4S-2): 59S-68S.
14. Wang F, Garza LA, Kang S, Varani J, Orringer JS, Fisher GJ, Voorhees JJ. In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol. 2007; 143: 155-163.
15. Paliwal S, Fagien S, Sun X, Holt T, Kim T, Hee CK, et al. Skin extracellular matrix stimulation following injection of a hyaluronic acidbased dermal filler in a rat model. Plast Reconstr Surg. 2014; 134: 1224-1233.
This work is licensed under a Creative Commons Attribution 4.0 International License.