Anatomical Position of Hyaluronic Acid Gel Following Injection to the Infraorbital Hollows

Abstract

In most specimens, the location of a significant portion of hyaluronic acid gel following injection to the infraorbital hollows differed from the intended injection plane. Soft tissue structures including fat compartment septa and the orbicularis oculi muscle appear to influence the resting position of hyaluronic acid gel. Careful attention should be used to avoid overfilling the thin soft tissue layers of the medial infraorbital hollows or tear trough.

Microanatomical Location of Hyaluronic Acid Gel Following Injection of the Temporal Hollows

“…4 Injection of HA gel into cadaveric infraorbital hollows resulted in a significant portion of the material outside the intended injection plane, while injections into the eyebrow region showed a consistent preperiosteal location. 5,6 In this study, dehydration of fresh frozen cadaver skin and subcutaneous tissues could have challenged accurate injection. In live injections, the practitioner would redirect the needle more superficially when the skin does not elevate during injection.…”

“…5,6 The specimens were then embedded in paraffin and a single 4 µm section was utilized. The section was stained with hematoxylin and eosin and examined with a light microscope to determine the histoanatomical location of HA.…”

“…[1][2][3] The microanatomical location of HA fillers has been described after in-vivo nasolabial fold injections, 4 and after infraorbital hollow and eyebrow injection in cadavers. 5,6 To the best of the authors' knowledge, there have been no histoanatomical studies directly evaluating HA gel position after injection within the temporal hollow. The authors sought to evaluate the position of HA gel using tissue histology after subcutaneous injection to the temporal hollows.…”

Anatomical Position of Hyaluronic Acid Gel Following Injection to the Eyebrow

“…11 The authors previously reported the histoanatomical position of hyaluronic acid gel injected to the preperiosteal plane of the infraorbital hollows. 11 While using the lower eyelids/midface of the same cadaver specimens that were used in the current report, the previous study found a significant portion of filler either within a postorbicularis or subcutaneous plane in 8 of 10 lateral or central lower eyelid/midface sections.…”

Evolving Minimally Invasive Techniques for Tear Trough Enhancement

“…[2][3][4] Bony remodeling and soft tissue descent and atrophy cause loss of the youthful convexity found in the lower eyelid. 5 The maxillary bone may begin to retrude relative to the position of the globe, the cheek tissues descend inferiorly and medially, and the orbital fat may prolapse producing a bulge in the lower lid. The combination of these factors causes what is known as the double convexity deformity and results in demarcation of the inferior orbital rim.…”