Revolutionizing tear trough rejuvenation: A novel bilaminar approach with differential rheologic G prime fillers

Facial aging, marked by soft tissue atrophy, ptosis, and midfacial structural changes, has amplified the role of dermal fillers in modern aesthetic practice. The bilaminar injection technique leverages the distinct rheological properties of high and low G prime hyaluronic acid fillers to enable dual-plane facial rejuvenation-deep structural support and superficial contour refinement. This case series investigates the clinical efficacy and safety of this technique in correcting tear trough deformities.

The study was conducted in a single-center institutional aesthetic setting. Five patients (aged 25-60 years) presenting with midface volume loss and tear trough concerns for both the eyes were included following clinical assessment. Randomization and masking were not applied due to the nature of the procedure. A bilaminar approach was adopted: high G prime fillers were injected supraperiosteally to reinforce & augment deep structures, while low G prime fillers were deposited subdermally for fine contouring. All procedures were performed under aseptic conditions using a combination of needle and cannula techniques.

Primary outcomes included periorbital volume restoration and contour correction assessed at a 2-week follow-up. Adverse events and patient satisfaction (measured via visual analog scale) were also documented for 3-6 months. All patients exhibited visible improvement in midface volume and tear trough contour, with high satisfaction scores. Transient ecchymosis and edema were the only noted minor side effects.

The bilaminar technique offers a precise, anatomically harmonious, and well-tolerated approach to tear trough rejuvenation, establishing itself as a sophisticated tool in advanced facial aesthetics.