Friday, February 4, 2011

Hyaluronic Acid Injections for Tear Trough Deformities

Hyaluronic Acid Injections for Tear Trough Deformities

There are many options that are available to treat the tear trough deformities.  These include: fat injections, malar implant/prosthesis, pedicled fat, hyaluronic acid dermal filler injections, etc.  The advantages of using hyaluronic acid injections, such as Juvederm and Restylane, are that this method avoids the downtime of surgical options and is minimally invasive. 
Photograph by Biswarup Ganguly (File Courtesy of Wikimedia Commons)
Surgical & Non-surgical Options for Tear Trough Deformities
  • Autologous fat graft/transfer
  • Hyaluronic Acid Injections
  • Alloplastic Implants (such as, Silicone implants placed in front of the cheek.)
  • Release of the orbicularis oculi muscle origin (muscles around the eye), and transposition of pedicled orbital fat.
Fast Facts about Hyaluronic Acid Injections for Tear Trough Deformities
  • The dermal filler is injected at the level of the periosteum (tissue above the bone) to reduce the risk of palpability and surface irregularities.
  • Surface irregularities from dermal filler injections occur when these injections are done superficially, such as the superficial & deep dermis of the skin, subcutaneous (tissue under the skin) or suborbicularis oculi fat (fat underneath the lower eyelid muscle, orbicularis oculi).
  • Injection at the level of the periosteum improves the longevity of the filler since it is placed where the tissue is not mobile.
  • Like any dermal filler injections, the treatment of tear trough deformities using dermal fillers, such as Restylane, Juvederm or even Radiesse, may last for several months depending on which dermal filler is used.
  • According to a recent study, the results lasted from 6 to 12 months.
  • A dermal filler injection for tear trough deformities is not for everyone.  A transconjunctival blepharoplasty for the lower eyelid or other procedures may be necessary.
I recommend  these treatments to be performed by one of your Houston plastic surgeons who will determine whether a dermal filler injection is right for you.  Choosing a medical provider who has a solid knowledge of the anatomy of the face, and has good surgical judgment is essential to minimize the potential complications (such as blindness and facial necrosis) that may arise from a dermal filler injection.  Your plastic surgeon will guide and recommend you the best possible treatment option for your tear trough deformity problem.


Emmanuel De La Cruz M.D.
The Woodlands Plastic Surgeon

References:
Flowers RS. Tear trough implants for correction of tear
trough deformity. Clin Plast Surg 1993;20:403-415.

Loeb R. Fat pad sliding and fat grafting for leveling lid
depressions. Clin Plast Surg 1981;8:757-776.
Kane MA. Treatment of tear trough deformity and lower eyelid bowing with injectable hyaluronic acid. Aesthetic Plast Surg. 2005 Sep-Oct;29(5):363-7.
Lambros VS. Hyaluronic acid injections for the correction of the tear trough deformity.
Plast Reconstr Surg. 2007 Nov;120(suppl 6S):74S-80S
Viana, et al.  Treatment of the Tear Trough Deformity With Hyaluronic Acid Aesthetic Surgery Journal February 2011 31: 225-231

Date Updated:  April 8, 2011

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