Hyalurostructure treatment: superior clinical outcome through a new protocol-a 4-year comparative study of two methods for tear trough treatment.

Berros, Philippe; Lax, Lilian; Bétis, Frédéric · Plast Reconstr Surg · 2013

prospective_cohort · Level II

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Abstract

The tear trough represents a main aesthetic characteristic of the aging process, which leads many patients to the wish for a safe and efficient rejuvenation method to fill their eye rings. The authors analyzed results and complication rates of two methods for hollow eye ring treatment. The authors used two methods on two patient collectives. Group A was treated using hyaluronic acid gel (Restylane; Q-Med, Uppsala, Sweden) and a reinforced 25-gauge Pix'l+ micro cannula. The authors developed a modified method for group B that included a combination of cooling of the periorbital area, no local anesthesia, preincision displacement of malar fat 10 mm below the orbital border, and postintervention corticoid therapy for 48 hours. Protocol B was associated with significantly lower complication rates. The authors also analyzed in how smoking, age, and skin properties might affect the clinical outcome. They found that choice of treatment and a history of blepharoplasty were significant predictive factors that correlated with complications. Tear trough treatment by hyalurostructure shows satisfying and efficient results with few complications. The revised technique used in group B combines multiple peri-interventional procedures including preinjection cooling of the periorbital area, preincision with displacement of the malar fat 10 mm below the orbital border, applying gentle back-and-forth movements while injecting, and oral corticosteroid therapy 48 hours after intervention. This technique makes hyalurostructure a competent and promising treatment for tear trough management. Therapeutic, III.

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