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Understanding Tear Trough Fillers
Tear trough fillers are designed to address the appearance of hollows under the eyes, also known as tear troughs or nasolabial folds.
The location where tear trough fillers are injected is a critical aspect to understand for optimal results and minimized risks.
The tear trough area is situated below the bony orbital rim, approximately 1-2 cm away from it, and extends from the lateral canthus (outer corner of the eye) to the medial canthus (inner corner of the eye).
The anatomy of this region consists of several layers:
The superficial layer contains the dermis, a layer of connective tissue that supports the epidermis (the outermost layer of skin).
Below the dermis lies the subcutaneous fat, which provides cushioning and structure to the face.
The deeper layer consists of muscles, tendons, and ligaments, including the zygomaticus major muscle, which helps control facial expressions.
In terms of specific injection sites:
Tear trough fillers are typically injected into the subcutaneous fat layer, just below the orbital bone, using a technique called “intradermal placement.”
This means that the filler material is inserted into the dermis, rather than directly beneath it.
Injecting into the subcutaneous fat layer helps to create a more subtle and natural-looking effect, while also minimizing the risk of complications such as infection or scarring.
The ideal injection site for tear trough fillers is typically located:
About 1-2 cm away from the orbital bone, in line with the facial midline (the imaginary line that divides the face into two equal halves).
Just below the bony prominence of the orbital rim, where the bone and skin meet.
A gentle “trickle” injection technique is often used to distribute the filler material evenly throughout this area, ensuring optimal coverage and minimizing discomfort.
Understanding the anatomy and correct injection location are essential for successful tear trough fillers treatment, as they can significantly impact the final results and patient satisfaction.
Skilled practitioners use a combination of clinical expertise, anatomical knowledge, and imaging guidance (such as ultrasound or photoacoustic imaging) to accurately identify the optimal injection site and deliver effective treatment.
This comprehensive approach helps to achieve natural-looking results while minimizing risks associated with tear trough fillers injections.
Tear trough fillers are a type of injectable dermal filler used to address the hollows under the eyes, also known as tear troughs. To effectively use these fillers, it’s essential to understand where they are typically injected.
The tear trough area is located below the eyes, starting from the nasal bridge and extending laterally to the outer corner of the eye. This area can appear hollow or sunken due to a combination of factors, including:
- Loss of fat and tissue in this area due to aging
- Drooping skin and muscle tissues under the eyes
- Skeletal structures of the face, such as the orbits and zygomatic bones, that can contribute to a more prominent tear trough
- Gravity’s effect on the skin and soft tissues around the eyes
To address these concerns, tear trough fillers are injected into the following areas:
- Nasojugal fold**: This is the area located under the eye, connecting the nose to the temple. Fillers are often injected into this area to restore lost volume and reduce the appearance of hollows.
- Malar fat pad**: The malar fat pad is a soft tissue structure located in the cheek area that contributes to the overall shape of the face. Injecting fillers into this area can help lift and contour the tear trough area.
- Suborbicularis oculi muscle**: This muscle is responsible for the movement of the eye, and injecting fillers into its insertion site under the eyebrow bone can help reduce the appearance of a hollowed-out look.
In general, tear trough fillers are typically injected using a fine needle and small amounts of filler material. The injection process itself should be done in such a way that minimizes any potential discomfort or bruising. It’s essential to work with an experienced healthcare professional or dermatologist who has extensive knowledge of tear trough fillers and their proper application.
During the procedure, the healthcare professional will typically use a local anesthetic to numb the area, and may also use a mirror or other visualization aids to guide the injection process. The filler material will be inserted into the desired areas using a small needle, and the healthcare professional will then gently massage the area to distribute the filler evenly.
After the procedure, it’s essential to follow proper post-injection care instructions to minimize any potential risks or complications. This may include avoiding strenuous activities, applying cold compresses to reduce swelling, and taking medication as prescribed by your healthcare professional.
The tear trough area, located underneath the eyes, refers to the hollows that can create a tired or aged appearance on the face. This area contains orbital fat pads, which are responsible for maintaining the smoothness and contours of the eyelids.
When injectable fillers are used to address concerns in this area, they are typically administered into the tear trough to restore a more youthful and radiant appearance. The goal is to add volume, reduce the appearance of dark circles, and create a brighter, more refreshed look.
In order to effectively treat the tear trough, the filler must be injected into the correct location. The orbital fat pads are made up of multiple layers of tissue, including the orbital septum, which is a thin membrane that separates the fat from the muscle underneath.
To target the tear trough area, the injector will usually aim for a spot just lateral to the lacrimal bone, approximately 1-2 millimeters below the bony prominence. This location allows the filler to be placed within the orbital fat pads, where it can help restore lost volume and smooth out the area.
It’s worth noting that injecting fillers into the tear trough requires a high level of precision and skill, as the area is highly anatomical and can be prone to complications. The injector must have a thorough understanding of facial anatomy and the characteristics of the orbital fat pads in order to successfully administer effective treatment.
Additionally, injectors should also take into account the type of filler being used and its properties. Different fillers have varying levels of durability, spreadability, and absorption rates, which can affect their suitability for use in the tear trough area.
In general, fillers that are well-suited for this treatment include hyaluronic acid-based products like Restylane or Juvederm, as well as calcium hydroxylapatite fillers such as Radiesse. The choice of filler will depend on individual factors, including the injector’s preference and experience, as well as the patient’s skin type, concerns, and desired outcomes.
It’s also worth noting that the tear trough area can be a sensitive location, and some patients may experience redness, swelling, or bruising at the site of injection. The injector should take steps to minimize these risks by using gentle techniques, administering the filler in small amounts, and avoiding areas with poor perfusion or fragile skin.
Overall, understanding where to inject tear trough fillers is crucial for achieving effective results while minimizing potential complications. A thorough knowledge of facial anatomy, combined with a keen eye for detail and a skilled hand, is essential for creating natural-looking, long-lasting beauty solutions in this area.
The tear trough filler is injected into a specific area of the face to address concerns related to dark circles, discoloration, and hollows under the eyes.
To understand where this filler is injected, it’s essential to first comprehend the anatomy of the area.
The tear trough area is located between the orbital bone and the orbital fat pad, which is a fatty tissue that fills the space between the eyeball and the surrounding bones.
More specifically, the filler is typically administered into the lateral orbital floor, just beneath the arcus marginals, which is the fibrous ring that attaches to the tarsal plates of the eyelids.
This injection site allows the filler to target the area of concern while minimizing potential side effects and complications.
The anatomy of the tear trough area consists of several key structures, including the orbital bone, orbital fat pad, and the lacrimal sac.
The orbital bone forms the lower rim of the eye socket and provides a framework for the surrounding tissues to attach to.
The orbital fat pad is a layered fatty tissue that fills the space between the orbital bone and the eyeball, providing cushioning and support.
The lacrimal sac is a small, pear-shaped structure located beneath the orbital bone, responsible for producing tears that help lubricate and protect the eyes.
When filler is injected into this area, it can effectively address concerns related to dark circles, puffiness, and discoloration by filling in the hollows under the eyes and smoothing out the appearance of fine lines and wrinkles.
In particular, the lateral orbital floor injection site targets the following specific areas:
1. The arcus marginals: This fibrous ring is a key landmark for filler injection, as it provides a natural anatomical border for the filler to adhere to.
2. The orbital fat pad: By injecting filler into this area, the filler can effectively fill in the hollows under the eyes and reduce the appearance of fine lines and wrinkles.
3. The orbital bone: Injecting filler into the lateral orbital floor also allows it to target the underlying bony structure, providing a more stable and longer-lasting result.
A thorough understanding of these anatomical considerations is crucial for effective tear trough filler injection, as it enables practitioners to optimize their technique and achieve optimal results for patients.
Tear trough fillers are a type of dermal filler used to address concerns in the tear trough area, which is located under the lower eyelid and borders the orbital bone superiorly and the palpebral conjunctiva inferiorly.
The location of the injection site is crucial for effective treatment. The tear trough area is characterized by a natural dip or trough that runs from the lower lash line to the nasal corner of the eye.
To target this area, fillers are injected into the _subcutaneous fat layer_ just beneath the orbital bone and above the palpebral conjunctiva. This injection site allows for optimal absorption and distribution of the filler, as well as minimal risk of adverse reactions.
More specifically, the filler is typically administered in the following locations:
– **Supercilial area**: Just below the orbital bone, where the eyelid meets the forehead.
– **Lateral canthal area**: Alongside the lateral (outer) corner of the eye, from the lower lash line to the nasal corner.
– **Medial canthal area**: Alongside the medial (inner) corner of the eye, from the lower lash line to the nasal bone.
The precise placement of the filler within these areas helps to restore a more youthful and radiant appearance, while minimizing the risk of complications or unevenness.
It’s worth noting that the extent and location of the injection site may vary depending on individual factors, such as skin laxity, fat loss, or eyelid shape. A qualified practitioner will assess each patient’s unique anatomy and provide personalized guidance for optimal results.
Filling in the tear trough area can be achieved using a variety of fillers, including hyaluronic acid (e.g., Juvederm, Restylane), calcium hydroxylapatite (Radiesse), or polymethylmethacrylate (PMMA) (Sculptra). Each filler has its own unique characteristics, benefits, and potential risks, which should be discussed with a qualified practitioner.
Where Tear Trough Fillers are Injected
Tear trough fillers are injected into the hollows underneath the lower eyelids, also known as the tear troughs or infundibulum. This area is a natural depressions that can make the eyes appear sunken or tired.
The most common locations for tear trough filler injections are:
- Lower eyelid: The filler is injected just below the lash line, in the soft tissue of the lower eyelid.
- Medial canthus: The filler is injected into the area where the nasal bone meets the lacrimal bone (medial canthus), to create a more lifted and awake appearance.
- Infundibulum: Filler can also be injected directly into the infundibulum, the hollow space underneath the lower eyelid.
Subtypes of filler injections include:
- Hyaluronic acid fillers (e.g. Restylane, Juvederm): These are popular for tear trough fillers due to their ability to provide a natural-looking and feeling result.
- Calcium hydroxylapatite fillers (e.g. Radiesse): These fillers are also used for tear trough injections, particularly in areas with thin skin or poor vascularity.
- Poly-L-lactic acid fillers (e.g. Sculptra): These fillers can be used to create a more permanent and long-lasting result, but may require multiple sessions.
It’s worth noting that the type of filler used for tear trough injections will depend on several factors, including:
- The individual’s skin type and condition
- The desired level of lift and fullness
- The extent of facial volume loss
- The patient’s personal preferences and medical history
A qualified healthcare professional will assess the individual’s face and determine the best course of treatment using a combination of fillers, sometimes in conjunction with other treatments such as botulinum toxin injections or surgical procedures.
The tear trough area is a complex region that requires precise placement of fillers to achieve optimal results.
Lateral cannthal injection, also known as lateral canthal filler injection, is a technique used to treat tear trough deformity and facial asymmetry in the mid-face region.
The lateral cannthal area is located between the lateral canthus (the outer corner of the eye) and the medial canthus (the inner corner of the eye).
In this region, fillers are injected into the subcutaneous tissue, just beneath the mucous membrane that lines the lower eyelid.
The exact location of injection is typically determined by the individual’s anatomy and the desired outcome.
Fillers are usually administered in a small, triangular area between the lateral canthus and the orbital rim, near the junction of the soft tissue and bone.
This specific placement allows for optimal correction of tear trough deformity, as well as addressing facial asymmetry and hollows under the eyes.
The injection technique is carefully performed to avoid damaging surrounding tissues or structures, such as the nerve endings or blood vessels.
Using a fine needle, the filler material is slowly injected in a controlled manner, allowing for precise placement and minimizing the risk of complications.
The final placement of fillers in this region should be evaluated under the skin to ensure even distribution and optimal results.
The entire process should take around 15-30 minutes, depending on individual factors such as filler type and amount.
The injection site for tear trough fillers can be a bit tricky to understand, but it’s an important factor to consider when choosing a treatment.
Lateral cannthal injections involve injecting fillers into the lateral corner of the eye, just below the orbital bone.
This is typically done to address the nasolabial fold and provide support and volume to the hollow area under the eye.
The term “cannthal” comes from the medical terminology for the corner or angle of the eye, and in this case, it refers to the lateral (outer) cannthus, which is the outer corner of the eye.
By injecting fillers into this area, the filler can help to lift and fill out the hollow space under the eye, creating a more youthful and rested appearance.
The orbital bone forms the bony structure of the eye socket, and in the case of lateral cannthal injections, the filler is injected just below this bone.
This area is also known as the _Cannhal_ region, and it’s a common site for tear trough fillers to be injected due to its accessibility and the fact that it provides a clear indication of where the filler is placed.
Other areas where tear trough fillers can be injected include:
-
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- The _Radial_ corner, which involves injecting filler into the inner corner of the eye.
- The _Palpebral_ region, which is the area between the eyelid and the orbital bone.
- The orbital fillers are also used for more complex conditions such as the hollows under the cheekbones, along with the tear troughs.
In terms of technique, the injection site is typically determined by the individual’s unique anatomy and the areas they wish to target.
A qualified healthcare professional or aesthetic practitioner will use a combination of visual inspection and anatomical knowledge to determine the best placement for the filler.
They may also use imaging technologies such as ultrasound or 3D scanning to ensure accurate placement and avoid any potential complications.
The exact technique used can vary depending on the type of filler being used and the individual’s specific needs.
The tear trough area, also known as the infraorbital hollow, is a common concern for many individuals, particularly those with periorbital skin laxity and dark circles under the eyes.
In order to effectively address this area, medical professionals often use dermal fillers such as hyaluronic acid, calcium hydroxylapatite, or poly-L-lactic acid to restore lost volume and smooth out the appearance of deep-set eyes.
The most common location for tear trough filler injection is in the
In this region, a fine needle is inserted at an angle of 20-30 degrees to minimize discomfort and maximize effectiveness. The filler material is then carefully injected into the
The goal of this injection site is to restore lost volume in the tear trough area, while also minimizing the risk of complications such as eyelid retraction or visual disturbances.
Other potential injection sites for tear trough fillers include the
It’s worth noting that not all tear trough fillers can be injected in the medial canthal region, as some products may have specific indications or restrictions for use in certain areas of the face.
As with any medical procedure, it’s essential to consult with a qualified healthcare professional or board-certified dermatologist to determine the best course of treatment for your individual needs and concerns.
They will be able to assess your facial structure and recommend the most effective injection site and filler material for achieving optimal results and minimizing potential risks.
In order to address the concern about tear trough filler injections, it’s essential to understand the anatomy of the eye and where these fillers are administered.
Tear trough fillers are injected into the mid-palpebral fold, which is the area that connects the nose to the eye. This region is located medial to the orbital rim and inferior to the levator palpebrae superioris muscle.
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More specifically, the injections are made in the vicinity of the lacrimal sulcus, which is a groove on the lateral side of the nasal bone that marks the junction between the orbital surface and the facial surface. This location allows for the optimal placement of the filler to correct the tear trough deformity.
The medial canthal injection site is carefully targeted to avoid any blood vessels or nerves in the area, ensuring a safe and effective treatment outcome.
During the procedure, the injector will typically use a small needle to insert the filler under the skin of the mid-palpebral fold. This may involve some gentle manipulation of the soft tissues around the eye to achieve the optimal placement of the filler.
The specific injection site may vary depending on the individual’s anatomy and the type of filler being used. However, in general, tear trough fillers are injected into the medial corner of the eye, towards the nose, using a technique that is both minimally invasive and highly precise.
Guidelines and Considerations for Tear Trough Fillers
Tear trough fillers are injected into the tear troughs to correct hollowing and sagging of the lower eyelid, resulting from loss of fat and skin elasticity with age.
The location where tear trough fillers are injected is a critical consideration to ensure optimal results and minimize potential side effects. The primary area for injection is below the orbital rim, in the nasojugal fold.
More specifically, the filler is typically administered along the medial canthal tendon, which runs from the medial angle of the eye to the nasal bone. This region provides adequate support and structure for the eyelid and helps restore a more youthful appearance.
The injection site should be carefully selected to avoid the following areas:
– The orbital fat pads, as injecting into these areas can lead to overfilling, inflammation, or even fat embolism.
– The lacrimal sac and conjunctiva, as direct access to these structures can cause irritation, redness, or even tear duct problems.
– The facial nerve and surrounding tissues, as injury to these areas can result in numbness, weakness, or paralysis of the eyelid or face.
Additional considerations for tear trough filler injection sites include:
– Symmetry: Filling one side of the tear trough at a time may provide better results and allow for more accurate placement.
– Depth: Injecting too close to the bone can cause palpability, whereas injecting too far away may not provide sufficient volume.
– Angle of injection: The optimal angle is between 15° to 30°, which allows for a more natural distribution of the filler material.
Understanding these guidelines and considerations for tear trough filler injections enables practitioners to deliver effective treatments while minimizing potential complications and maximizing patient satisfaction.
Ultimately, it is crucial to carefully assess each patient’s anatomy and unique needs before selecting an injection site to achieve optimal results with minimal side effects.
Tear trough fillers are injected into the tear trough, a hollow area under the *orbit* (the bony ridge that surrounds the eye), to address concerns of sagging skin, dark circles, and a tired appearance.
The injection site for tear trough fillers is typically located in the mid-portion of the *cheek bone*, about one to two millimeters below the *orbital rim*. This area is accessible through various injection routes, including the nasal (nasal mucosa) route and the sutural (suture line) approach.
The nasal route involves injecting the filler into the skin of the *nose* or *nasolabial fold*, while the sutural approach involves inserting the filler just below the *suture lines* that connect the *frontal bone* and *orbital rim*. Both routes allow for precise placement of the filler in the tear trough area.
The ideal injection site depends on individual facial anatomy, the type of filler used, and the desired outcome. Generally, a central or bilateral approach is preferred to ensure even distribution and maximum efficacy.
A **cautious** and precise technique is essential when injecting tear trough fillers, as the surrounding skin is delicate and can be easily irritated. The injector must take care not to overfill or underfill the area, as this can lead to unsatisfactory results.
The type of filler used for tear trough fillers also plays a crucial role in determining the injection site. For example:
– **Hyaluronic acid fillers**, such as *Restylane* and *Juvederm*, are often injected into the mid-portion of the cheek bone, using a nasal route or the sutural approach.
– **Calcium hydroxylapatite fillers**, like *Radiesse*, can be injected into both the nasal mucosa and the skin of the nasolabial fold.
– **Poly-L-lactic acid fillers**, such as *Sculptra*, may require a more sutural approach, with injections placed just below the suture lines to create new collagen production.
A thorough understanding of facial anatomy and the specific characteristics of each filler type is crucial for selecting the most suitable injection site. Ultimately, the injector’s expertise and experience will guide the best course of treatment to achieve optimal results.
Tear trough fillers are a popular treatment option used to address the hollow appearance under the eyes, creating a more youthful and radiant look.
To determine the best placement for tear trough filler injections, it’s essential to consider several guidelines and factors.
A thorough understanding of anatomy, as well as patient-specific needs and concerns, is crucial in selecting the most effective treatment approach.
- Identifying the correct injection site: The primary goal of tear trough filler injections is to address the hollow appearance under the eyes, which can be achieved by targeting specific areas with fillers.
Injections should be placed along the orbital rim, approximately 6-8mm lateral to the lateral orbital margin, and 1-2cm above the infraorbital crest.
- Understanding facial anatomy: The tear trough area is bordered by several key anatomical structures, including the orbital rim, the infraorbital crest, and the supratrochlear nerve.
A thorough understanding of these structures is essential to avoid potential complications, such as numbness or bruising, caused by injection near the supratrochlear nerve.
- Assessing tear trough depth: The depth of the tear trough can vary significantly from one individual to another, and fillers should be selected based on their ability to address specific needs.
Hyaluronic acid (HA) is commonly used for shallower tear troughs, while calcium hydroxylapatite (CaHA) may be more suitable for deeper defects.
- Considerations for patient-specific factors: Patient-specific factors, such as skin type and texture, facial structure, and medical history, should also be taken into account when selecting a tear trough filler.
Patients with darker skin tones may require more extensive treatment or the use of specific fillers to achieve optimal results.
- Guidelines for filler placement: When injecting tear trough fillers, it’s essential to follow established guidelines to ensure optimal results and minimize potential complications.
Filler should be placed in a linear fashion along the orbital rim, rather than in a radial or zig-zag pattern, which can increase the risk of complications.
- Post-injection care: Proper post-injection care is crucial to ensure optimal results and minimize potential complications.
Patients should be advised to avoid strenuous activities, massage the treated area, and use cold compresses to reduce swelling and bruising.
In conclusion, tear trough filler injections require a thorough understanding of anatomical structures, patient-specific needs, and guidelines for proper placement and post-injection care. By following these considerations, practitioners can achieve optimal results while minimizing potential complications.
Tear trough fillers are a type of dermal filler used to address the signs of aging and volume loss in the mid-face, particularly in the tear trough area.
The tear trough is an anatomical region that spans from the bridge of the nose to the pre-oral Seam, where it merges with the nasolabial folds. The tear trough can become visible and deepened over time due to loss of facial fat, bone resorption, and gravity.
The American Society for Dermatologic Surgery (ASDS) and the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) have established guidelines for the use of tear trough fillers.
- In 2017, the ASDS published a position paper on the use of dermal fillers in facial aesthetics, which includes guidelines for the treatment of the tear trough area.
- The ASFD and ABFPRS also recommend that injectors follow a step-by-step approach when treating the tear trough:
Step 1: Anatomical Identification
Identify the correct anatomical landmarks for injection, including the superior orbital rim, lateral canthus, and nasolabial fold.
Step 2: Patient Evaluation
Evaluate the patient’s facial structure, skin texture, and previous treatments to determine the most suitable treatment plan.
Step 3: Selection of Filler Type and Amount
Choose a filler that is suitable for the tear trough area, taking into account factors such as volume replacement, texture, and .
Step 4: Injection Technique
Use a nasojugal approach or superior orbital rim approach to minimize discomfort and maximize efficacy.
Step 5: Monitoring and Follow-up
Monitor the patient’s response to treatment and adjust as needed, with follow-up appointments scheduled at 1-2 weeks and 6-8 weeks after treatment.
The American Society for Dermatologic Surgery (ASDS) also recommends that injectors:
- Follow a conservative approach when treating the tear trough, using the least amount of filler necessary to achieve the desired result.
- Avoid over-injection or overfilling, which can lead to adverse reactions and complications.
- Use high-quality fillers that are CE-marked and have a clear indication for use in the tear trough area.
- Follow proper sterile technique and infection control protocols when performing injectors.
Risks and Complications
Common risks and complications associated with tear trough fillers include:
- Infection: Bacterial, viral, or fungal infections can occur at the injection site.
- Necrosis: Death of skin tissue due to insufficient blood supply or improper technique.
- Allergic reactions: Mild to severe reactions to filler materials or preservatives.
- Scarring: Temporary or permanent scarring can occur at the injection site.
The ASDS recommends that injectors take a thorough medical and surgical history, perform a conductive examination, and use topical anesthesia as needed to minimize discomfort during treatment.
Tear trough fillers are a popular treatment for reducing the appearance of hollows under the eyes, also known as _Tear Trough Dystrophy_ or _Periorbital Hollowing_.
When it comes to injecting tear trough fillers, there are several guidelines and considerations to keep in mind to achieve optimal results.
**Anatomical Considerations**: The tear trough area is a complex region, bounded by the *orbital fat*, *periosteum*, and *zygomatic bone*. To effectively treat this area, injectors must consider the underlying anatomy and spatial relationships between these structures.
The _Orbicularis Oculi muscle_* separates the tear trough area from the rest of the face. Injectors should avoid inserting the needle too close to this muscle, as it can cause unwanted complications such as eyelid ptosis or eyelid spasms.
The ideal injection site for tear trough fillers is in the mid-to-upper _orbital fat pad_, which is located between the *zygomatic bone* and the *_periorbital fascia_*. This area provides optimal correction of the hollowed appearance under the eyes without compromising facial symmetry or function.
**Technique Considerations**: The injection technique for tear trough fillers is crucial to achieving desired results. Injectors should use a small-gauge needle (typically 25-30 gauge) and a short, shallow needle stroke to minimize discomfort and reduce the risk of complications.
The filler material should be injected in a linear fashion along the _orbital floor_, with the tip of the needle placed within the mid-to-upper orbital fat pad. This helps to create a smooth, natural-looking contour without excessive swelling or bruising.
**Filler Selection and Quantity**: The choice of filler material is also critical when treating tear troughs. *_Hyaluronic acid_*, *_calcium hydroxylapatite_*, and *_poly-L-lactic acid_* are commonly used for this indication.
The quantity of filler required will depend on the individual’s unique anatomy, skin laxity, and desired outcome. Injectors should assess the volume of orbital fat loss and determine the optimal amount of filler needed to achieve a harmonious facial contour.
Overcorrection can lead to an unnatural appearance, while undercorrection may not provide sufficient improvement in tear trough depth. Injectors must carefully balance these factors to achieve the most satisfying results for their patients.
A thorough understanding of anatomical relationships, injection techniques, and filler selection is essential for effective treatment of tear troughs using fillers. By following ASLHS guidelines and considering individual patient anatomy, injectors can provide optimal correction of this common aesthetic concern.
The tear trough area is a sensitive region that requires careful consideration when selecting a filler and technique to avoid complications.
In general, tear trough fillers are injected into the pre-jowl zone, which is the area of the face between the cheekbones and the nose.
More specifically, the injections are targeted at three distinct zones:
The lateral orbital wall, which is the bony structure adjacent to the tear trough;
The orbital rim, also known as the orbital margin, which is the curved edge of the eye socket;
The pre-jowl area, which is the fatty tissue beneath the bone that separates the cheek from the nose.
When selecting a filler for the tear trough, it’s essential to consider several factors, including the patient’s skin type, age, and desired outcome.
The FDA recommends using fillers with an approved mechanism of action that is supported by clinical evidence, such as hyaluronic acid (HA) or calcium hydroxylapatite (CaHA).
For the tear trough, HA fillers are often preferred due to their high water content and ability to mimic the natural appearance of hyaluronic acid in the body.
When injecting fillers into the tear trough, it’s crucial to use a gentle, controlled motion to avoid overfilling or causing bruising.
The recommended technique involves creating a small puncture wound with a 30- or 32-gauge needle and injecting the filler in a linear fashion, following the natural anatomy of the area.
It’s also essential to consider the patient’s facial expression and muscle activity when placing fillers in the tear trough, as this can help determine the optimal placement and amount of filler needed.
The ASLMS emphasizes the importance of following proper technique and using the most appropriate filler type for each patient, as recommended by the FDA, to minimize the risk of complications and ensure optimal results.
Furthermore, the Society recommends that injectors take the time to evaluate their patients’ facial structure and skin characteristics before making a recommendation for a particular filler or treatment plan.
This involves assessing the depth and contours of the tear troughs, as well as the overall shape and volume of the face.
Additionally, the Society highlights the importance of proper patient selection and informed consent, ensuring that patients are fully aware of the potential benefits and risks associated with tear trough fillers.
This includes discussing factors such as filler type, placement, and duration of results, as well as potential complications like bruising, swelling, or facial asymmetry.
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