INTRODUCTION
Tear trough (infraorbital area) hollow is a common age-related aesthetic concern, caused by volume loss or displacement, and a major reason for patients requesting periorbital rejuvenation.1,2 Hyaluronic acid (HA) fillers are commonly used to replace lost or displaced facial volume. With its clinical experience in facial rejuvenation of 25 years and over 50 million treatments (data on file), Restylane® has been successfully used as a targeted under-eye treatment in managing tear trough deformities.1,3-5
Effective facial rejuvenation with HA fillers requires a combination of precise anatomical understanding and injection proficiency. The tear trough is acknowledged as a significantly challenging area to treat, with a detailed anatomy that evolves with specific age-related changes.1,2,6,7
Significant clinical experience with Restylane has shown a lasting and effective reduction in facial wrinkles and has demonstrated its safety in many regions of the face.1,8 Restylane is suitable for the majority of patients with regular facial anatomy, although special precaution is necessary for patients previously injected with permanent or highly cross-linked fillers.8
This paper aims to provide recommendations for the optimal use of Restylane in tear trough rejuvenation based on the consensus recommendations of a highly experienced cross-specialty group of injectors.
Essential Aspects of Facial Anatomy
Several factors contribute to the appearance of tear trough deformity, including descent of the cheek, loss of facial volume, suboptimal infraorbital malar complex, and a muscular defect between the orbicularis muscle and angular head of the quadratus labii superioris muscle.2,7 A tear trough deformity itself may contribute to the appearance of dark shadows under the eye.1
Effective facial rejuvenation with HA fillers requires a combination of precise anatomical understanding and injection proficiency. The tear trough is acknowledged as a significantly challenging area to treat, with a detailed anatomy that evolves with specific age-related changes.1,2,6,7
Significant clinical experience with Restylane has shown a lasting and effective reduction in facial wrinkles and has demonstrated its safety in many regions of the face.1,8 Restylane is suitable for the majority of patients with regular facial anatomy, although special precaution is necessary for patients previously injected with permanent or highly cross-linked fillers.8
This paper aims to provide recommendations for the optimal use of Restylane in tear trough rejuvenation based on the consensus recommendations of a highly experienced cross-specialty group of injectors.
Essential Aspects of Facial Anatomy
Several factors contribute to the appearance of tear trough deformity, including descent of the cheek, loss of facial volume, suboptimal infraorbital malar complex, and a muscular defect between the orbicularis muscle and angular head of the quadratus labii superioris muscle.2,7 A tear trough deformity itself may contribute to the appearance of dark shadows under the eye.1
