APRILINE® Normal. This is a non- permanent,
absorbable, injectable
material for the correction of soft tissue defects. APRILINE® Normal is produced by bacterial fermentation and
stabilised using a highly
concentrated water solution without addition of other acids or alkaloids (A.P.R.I. Modification). This technology creates the specific spatial structure of HA molecules through effective linkages by BDDE. The concentration of hyaluronic acid per APRILINE® Normal filler is 23 mg/ml. The quantity of filler used for patients is between 0.6 and 0.8ml.
Procedural technique The 14 patients who did not demonstrate contraindication to hyaluronic acid filler injections were selected. Standard manipulations were carried out: all the patients were photographed in sufficient lighting on the procedure day, at 30 and 90 days. Written informed consent was obtained from all the patients. The procedure
of filler injection was
conducted as follows: ■Patients are reclined at 45° as the tear trough deformity is better
Figure 2 Illustration indicating points where filler injections administered from various angles
in a procedure room using disposable equipment
■APRILINE® NORMAL hyaluronic acid filler is injected using needle 27G with 0.6-0.8ml per one patient. The needle is injected at 90 degrees to the skin surface, deep to the orbicularis oculi and periosteal tissue. The first injection is performed from the medial side, usually 0.5cm from the medial cantus. 3–4 injections below the
“APRILINE® Normal is produced by bacterial fermentation and stabilised using a highly
concentrated water solution without addition of other acids or alkaloids (A.P.R.I. Modification).
” visible in this position
■Ice is used for the anaesthesia by firmly applying it on the skin between the eyelid and the cheek for a few seconds
■The treated zone is cleaned and disinfected using Biseptine spray and a sterile compress
■Injection procedure is performed
orbital rim were made in total. To prevent the damage of the neurovascular bundle we recommend to inject the filler avoiding projection of the infraorbital nerve. 0.3–0.5ml of the filler was injected at once. The injected area is massaged gently for optimal filler distribution.
References
1. Wong CH, Hsieh MK, Mendelson B. The tear trough ligament: the tear trough ligament: Anatomical basis for the tear trough deformity.
Plast Reconstr Surg 2012; 129: 1392–402
2. Pasquale A De, Russa G. Hyaluronic acid filler injections for tear-trough deformity: injection
technique and high-frequency ultrasound follow-up evaluation. Aesth Plast Surg 2013; 37: 587–591
prime-journal.com | March 2015 ❚ Barton's grading system based on anatomic analysis
Class Clinical description I
II III
A volume loss is limited medially to the tear trough ligament. The patients also have a mild flattening extending to the central cheek
The patients exhibit volume loss in the lateral orbital area in addition to the medial orbit and they may have moderate volume deficiency in the medial cheek and flattening of the central upper cheek
The patients have a full depression circumferentially along the orbital rim medially to laterally
Conclusion Development
of the tear trough
ligament during ageing can be the reason for dark under-eye circles. Treatment with APRILINE® NORMAL hyaluronic acid filler (0.6-0.8ml) is a minimally invasive and effective solution for under-eye dark circles. Patients are typically highly satisfied with the aesthetic outcome from the use of this versatile product.
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