Management of Tear Trough with Hyaluronic Acid Fillers: A Clinical-Practice Dual Approach

Abstract

Introduction

Tear trough deformity (TTD) is currently a major concern for many individuals that seek periorbital rejuvenation. Among the different options currently available for treating TTD, hyaluronic acid (HA) filler injections have become increasingly popular.

Purpose

To provide a dual approach, direct and indirect strategies for treating TTD with HA fillers according to patient facial structure.

Methods

The current paper combined the authors’ experience with the currently available scientific evidence.

Results

The current study presents the authors clinical experience regarding TTD treatment and serves as a guide on the best therapeutic approach with HA fillers. For achieving good aesthetic outcomes, especially in TTD, it is crucial to have a detailed understanding of both facial anatomy and the individual characteristics of the HA fillers. Proper management of full-face facial rejuvenation should have into consideration three main pillars: structure, contour, and refinement.

Conclusion

Treatment of TTD should be addressed from a comprehensive perspective, including potential lack of structural support, as well as interventions on the dynamic processes involved in the problem. Additionally, HA fillers can be used to modulate mechanically muscle movement by either facilitating their action or decreasing contractility by reducing their movement. Clinicians can benefit from ongoing guidance on the use of these products in order to tailor and optimize treatments to patient’s requirements. Although HA filler injections have low rates of side effects, TTD was listed as the most challenging area to treat with HA. Therefore, TTD treatment should be performed only by well-trained and experienced specialists.

Keywords:

• tear trough deformity
• hyaluronic acid
• MD Codes
• MD Dyna Codes
• cohesivity
• periorbital region

Acknowledgments

Medical writing and editorial assistant services have been provided by Ciencia y Deporte S.L. and covered by a grant from Allergan. Support for this assistance was funded by Allergan Aesthetics, an AbbVie company.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

Dr Urdiales-Gálvez has received a grant from Allergan Aesthetics, an AbbVie company, for covering the medical writing services. Dr Farollch-Prats has received research grants from Allergan Aesthetics, an AbbVie company.

Additional information

Funding

Medical writing services has been provided by Allergan Aesthetics, an AbbVie company. Allergan did not participate in either data collection, analysis or redaction of the manuscript. Neither honoraria nor payments were made for authorship.