PROMOTION
HA FILLER TREATMENT OF INFRAORBITAL DARK CIRCLES
Dr Paraskevov explains why using APRILINE® hyaluronic acid fillers is an effective solution for the treatment of under-eye dark circles
T
HE HECTIC PACE OF life, fatigue, and sleep disorders put an additional strain on modern society, irrespective of age,
gender or ethnicity. These factors contribute to skin ageing as well as creating unappealing dark rings under the eye. There are various methods to combat these issues, with varying degrees of success. These include various types of peeling,
laser resurfacing,
lipofilling, and other therapeutic and surgical procedures. One modern, and highly effective alternative is hyaluronic acid (HA) based filler injections, such as the new generation of fillers brought out by Suisselle laboratories. APRILINE®
combines new
technologies to create a more pure, stable product with optimal visco-elastic properties to create perfectly natural, even enhancements with the additional benefit of being very easily injectable with predictable, reliable outcomes every single treatment. Wrinkling of the infraorbital
region is one of the most widely spread reasons for visiting a medical aesthetics specialist. Problems in this area are typically accompanied by the loss of bone density, decrease in the vertical and increase in the horizontal size of the cranium and increase in the size of the bony orbit. The maxilla is resorbed and the buccal fat pad is
84 ❚
Figure 1 Diagram indicating the location of tear trough ligament and surrounding tissue structures with key below
shifted inferiorly, causing nasolabial folds. We observe subcutaneous fat redistribution, with loss of tissue fullness in the periorbital and the maxillofacial area. Persistence or hypertrophy of the infraorbital fat is accompanied by the formation of fat sacs. Changes in the soft tissues lead to weakening of the orbital septum and subsequent protrusion of the adipose tissue in the infraorbital region. The volume loss in the infraorbital area also reveals formerly hidden fat bodies in the infraorbital area or ‘palpebral sacs’.
The tear trough ligament gets depressed even further, passing obliquely from the lateral part of the nose at the level of the medial angle of the eye downwards to the anterior part of the cheek below the middle
of the eyelid. The
descending shift of the adipose tissue in the infraorbital area to the weak orbital septum forms a more profound and wide orbit and biconvex deformity of the lower palpebra. Lost tissue fullness between the orbicular muscle of the eye and superjacent skin of the lower palpebra causes approximation of the tissues and makes the thin skin of the infraorbital area look darker leading to eye fatigue.
Anatomic substantiation Anatomists
dissected
ligament differently. In their study, having
define a tear trough 48
halves . of
cadaveric faces, Dr. Wong and co- authors described the ligament of the tear trough ligament as a true osteocutaneous ligament1
As demonstrated in Figure 1, it begins medially, at the level of the insertion
of the medial central
tendon, just inferior to the anterior lachrymal crest, to approximately the medial-pupil line. The histological evaluation confirmed the ligamentous nature of the tear trough ligament, with features identical to those of the zygomatic ligament. Intensity of the tear trough ligament can be estimated using the classification offered by Barton and Hirman. Usage of HA fillers provides for an
KEY ORL Orbital retaining ligament PZs Process-Zone Stress LLS Levator labii superioris Zmj The Zygomatic major Zmi The Zygomatic minor TTL The tear trough ligament Palpebral part of the OO Palpebral part of the orbicularis oculi Orbital part of the OO Orbital part of the orbicularis oculi
March 2015 |
prime-journal.com
effective and non-surgical correction of dark circles in the periocular area and tear trough deformity. In a study2
,
14 patients were injected with an HA dermal stabilised filler called
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96