The Blending Technique: A New Approach for Tear Trough Correction

Area of Science:

• Aesthetic Medicine
• Facial Anatomy
• Dermatology

Background:

• The tear trough area significantly reflects aging.
• Understanding the anatomy of preseptal, premaxillary, prezygomatic, and deep pyriform spaces is crucial for successful filler treatments.
• Orbital septum, tear trough, and orbicularis retaining ligaments' relationship is key.

Purpose of the Study:

• To analyze the anatomical relationship between the orbital septum origin and tear trough/orbicularis retaining ligaments.
• To classify patients undergoing tear trough filler treatment into 'innie' or 'outie' types.
• To describe a blending technique based on patient classification for tear trough deformity.

Main Methods:

• Analysis of the anatomical relationship between facial spaces and cheek fat compartments.
• Classification of patients into 'innie' or 'outie' tear trough deformities.
• Application of a blending technique for tear trough filler treatments.

Main Results:

• 38 patients (21 female, 17 male, mean age 53) were evaluated with a mean follow-up of 10.4 months.
• All patients presented with 'innie' type tear trough deformities (Hirmand Type II or III).
• 84.2% of patients showed significant improvement ('very much improved') following treatment with hyaluronic acid, with no complications.

Conclusions:

• The blending technique effectively corrects tear trough deformities and palpebromalar grooves.
• Patient classification into 'innies' or 'outies' based on anatomical landmarks guides treatment.
• 'Innie' patients benefit from preseptal space injections, while 'outie' patients require midface volumization.