Objectives: Learn the importance of periorbital analysis
Introduction: The periorbital area is of great importance for rejuvenation procedures, both surgical and non-surgical. It is also an area that has many pitfalls and risk. Missing these may result in both poor results and disasters. Examples include severe ectropion after surgery and blindness after HA injections.
Materials / method: Understanding limitations and possibility with different treatments is necessary for success. Thus a proper diagnosis must be done, this involves the position of the eyebrow, the activity of the corrugator, procerus, orbicularis occuli and frontalis muscles. Upper eyelid diagnosis should always consider ptosis, volume loss and skin excess, never forgetting how important the eyebrow position is for the appearance of the upper eyelids. Lower eyelid diagnosis involves tonus, fat excess, skin excess, depression along the tear trough and palpable malar groove but also very importantly the position
Results: When the periorbital area has been examined in a correct way treatment alternatives should be discussed with the patient and preferably this is done both in front of the mirror but also based on photographic documentation of the area. Treatment selection depends on patient desires but also the biological conditions. When rejuvenating the periorbit with fillers and neurotoxins a combination of these gives the most favourable outcome.
Conclusion: When treating the tear trough it is important to consider volumization of the midface as this will shorten the lower lid and improve the palpebromalar groove and the tear trough. Elevation of tear trough deformity to create a rejuvenated lower lid appearance or counteract congenital appearances here should involve diagnosis of the tightness of the tear trough ligament which can be done by so called push and pull test. In this presentation diagnosis and treatment techniques will be presented.
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