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Evolving Minimally Invasive Techniques for Tear Trough Enhancement.

Robert H Hill1, Craig N Czyz, Srinivas Kandapalli

  • 1*Plastic Surgery Ohio, The Eye Center of Columbus; †Department of Ophthalmology, The Ohio State University; ‡Section of Oculofacial Plastic and Reconstructive Surgery, Ohio Health Doctors Hospital, Ohio University, Columbus Ohio; §Department of Ophthalmology, Drexel University; and ‖Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennysylvania, U.S.A.

Ophthalmic Plastic and Reconstructive Surgery
|October 10, 2014
PubMed
Summary

Directly treating the tear trough with hyaluronic acid gel filler significantly improves tear trough deformity compared to cheek augmentation alone. Cheek augmentation alone showed no significant improvement in tear trough appearance.

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Area of Science:

  • Plastic Surgery
  • Dermatology
  • Aesthetic Medicine

Background:

  • Tear trough deformity is a common aesthetic concern.
  • Volumetric augmentation is a popular method for correction.
  • The optimal location for filler injection remains debated.

Purpose of the Study:

  • To compare the efficacy of infraorbital rim (tear trough) versus deep medial cheek augmentation for improving tear trough deformity.
  • To determine which treatment area yields greater aesthetic improvement.

Main Methods:

  • Prospective, single-blind study with 12 patients.
  • Randomized hyaluronic acid gel filler injection into tear trough on one side and cheek on the contralateral side.
  • Evaluation by masked observers assessing pre- and post-treatment standardized photographs for tear trough depth.

Main Results:

  • Significant improvement in tear trough depth after direct tear trough treatment (p = 0.0001).
  • No significant improvement in tear trough depth after cheek-only treatment (p = 0.0963).
  • Tear trough injections were more technique-sensitive; cheek augmentation had no complications, while tear trough injections had varying degrees of ecchymosis.

Conclusions:

  • Direct tear trough augmentation provides superior improvement for tear trough deformity compared to cheek augmentation when treating each area alone.
  • Physician choice of treatment area is critical when addressing tear trough concerns.