Resumen

Objectives: The tear trough and periorbital region are among the first areas to show visible signs of aging. This study aims to demonstrate the regenerative potential of the latest generation injectables and to show that it is possible to slow the progression of aging and correct visible signs in this region without resorting to surgery — at least in cases that are not in an advanced stage. Introduction: Over the past eleven years, I have treated the tear trough and palpebromalar groove using semi–cross-linked hyaluronic acid (HA) filler 15 mg/ml with a dermo-restructuring complex (A), either alone or in combination with: Non–cross-linked HA with dermo-restructuring complex (B) and PNT technology filler HA 15 mg/ml (C) for the periorbital region PNT technology filler HA 23 mg/ml (D) and resilient technology filler HA 25 mg/ml (E) for the zygomatic region, in cases requiring preparatory treatment of the overlying area. Materials / method: From 2014 to 2025, 126 patients were consecutively treated in the tear trough and periorbital region with a total of 432 injections. All patients underwent at least one treatment with (A), performed in two stages. In 90% of cases, combined treatments with (B), (C), (D), or (E) were also performed. Injection technique: needle in 74% of cases, cannula in 26%. All (A) treatments were performed with a multilayered technique and microboluses. Follow-up assessments: 1, 3, and 12 months post-treatment. Patient satisfaction was evaluated using a questionnaire. Results: Treatment areas: tear trough (92%), palpebromalar groove (56%), crow’s feet (42%), outer canthus (15%). Patient profile: 95% received their first tear trough treatment. Adverse events: bruising in 30% of patients; 2 cases of long-term product accumulation resolved with hyaluronidase; no major side effects reported. Satisfaction: high or very high in 95% of cases. Durability: stable results maintained for up to 15 months. Conclusion: The tear trough and periorbital region remain a demanding challenge due to their anatomical complexity and high aesthetic relevance. Semi–cross-linked HA with dermo-restructuring complex, used alone or in combination with non–cross-linked HA, PNT technology filler, and resilient technology filler, provides safe, predictable and long-lasting results when performed by experienced practitioners. This approach can be considered the current gold standard for rejuvenation of these areas.