Objectives: The purpose of this presentation is to provide the anatomy-based procedural guidelines of the ideal injection planes for filler injection in Asians.
Introduction: Sunken eye, tear trough, nasojugal groove and palpebromalar groove are frequently observed in aging patients or even in younger persons. These periorbital hollow can create a shadow in this area resulting in a tired look. Among these, tear troughs form at the border where the relatively thin skin of the eyebrow meets the relatively thick skin of the nose. Tear troughs appear in people of all ages. The tear troughs occur for various reasons; nonetheless, the reduction of volume in tissues surrounding the periorbital region is the most significant reason.
Materials / method: In addition, the reduction of volume in tissues surrounding the periorbital region is the most significant reason for pronunciation of tear troughs. Orbital fat herniation, stretching of the skin and volume changes in tissue can serve as additional causes. Dissecting a cadaver reveals two to three orbital retaining ligaments pinching the orbicularis oculi muscle.
Results: Unlike Caucasians, the levator palpebral superioris m. of Asians often do not attach to the dermis. Relative to Caucasians, the orbital fat in Asians extends further down, causing the eye to appear more swollen. However, with age, the orbital fat may decrease, leading to a pronounced orbital margin and to the appearance of a furrow below the eye which is also defined as a sunken eye.
Conclusion: In this presentation, I will mention on the clinical anatomy on the periorbital structures including the variations on the orbicularis oculi, the nature of the orbicularis retaining ligament (its attachment and elongation), and orbital fat compartments. In addition, the superficial veins underlying the muscle will be presented for the prevention of bruising after the injection.
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