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Esperienza personale di trattamento del Tear Trough mediante filler a base di acido ialuronico: una casistica di 45 casi.

An increasing number of women over 30 years of age complain about the presence of dark circles and blemishes such as swelling or emptying at the level of the tear trough region, which negatively affect the overall aesthetics of the face, which appears tired and washed out. Periocular area and lower eyelid are particularly delicate areas, with very thin, sensitive skin, and anatomically characterized by finely vascularized dermis innervated by branches of the infraorbital nerve. Therefore, aesthetic treatments such as fillers of the tear trough are not widely practiced because the outcomes and real benefits are uncertain. The aim of this case series is to verify the efficacy and safety of a superficial injection of a hyaluronic acid- based filler with peculiar rheological characteristics in the treatment of youthful blemishes affecting the suborbital region and the lacrimal groove. A total of 45 women, ranging in age from 27 to 72 years old, were consecutively treated from 2021 to 2022. The product used for the procedure is a filler with 25 mg/mL of ultrapure HA, obtained by SHYALT technology, with high cohesiveness, a G’ of 39 Pa and a tan delta of 0.53 making it distinctive for its moldability post-implant. The guide needle was inserted 1 cm superficially and parallel to the skin near the zygomatic prominence in the eye direction. The cannula (25G, 50 mm) was then introduced all the way to the inner canthus of the eye in a fan-like movement to cleave the anatomical plane. Microdrops of product for a total amount of 0.1 mL per sulcus were injected with a linear retrograde movement; at the end of the procedure, a massage using an arnica-based gel was performed. The superficial placement of the product in small amounts and its peculiar rheological characteristics resulted in a smooth reshaping and plumping of the treated area without the occurring of any severe edema or Tyndall Effect. The presence of a considerable amount of soluble fraction of HA provided a detectable biorevitalizing effect on the skin overlying the area, with improvement in skin texture and color. Correction of mild/moderate grade tear trough by means of a superficial injection technique of an HA-based product proved to be effective and safe, making it a viable treatment option avoiding surgery procedures. The product was found to be optimally integrated, malleable and tissue-distributable, with an improvement in such a delicate and anatomically complicated region of the face.

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