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Objectives: The US FDA estimates that there are over 12,500 cosmetic ingredients in the cosmetics we use. Less than 20% of these ingredients have been assessed for safety. Cosmetic ingredients can contain toxins and unregulated, cumulative use can paradoxically contribute to ageing and worse aesthetics. I will present the findings of the largest literature review on Cosmetics and Procedures and the adverse events to the eye and periocular area. When we are chasing lines and wrinkles with neuromodulators, fillers and surgery, there is the elephant in the room that is the unregulated use of toxic beauty.

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Objectives: To demonstrate how a degree of lower lid fat herniation resulting in unsightly fat “ bags” can be improved by regional filler augmentation, without recourse to surgery.

Introduction: Some regional aesthetic benefits are realised quite serendipitously.
Some years ago the presenter noted unanticipated improvements in lower lid fat “bag” herniation after injecting the deep malar tissue spaces/deep fat pads for the objective of cheek contour enhancement.

Materials / method: Clinical cases are reviewed that demonstrate what could be termed “injectable” lower lid blepharoplasty.

Results: Non-surgical lower lid aesthetic enhancements are possible in suitable case presentations of malar filler augmentation.

Conclusion: As in this case of this unplanned experience, an observation of unanticipated regional aesthetic benefits can inspire a search for the mechanism that may explain the effect.

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Objectives: Recognizing the multifactorial nature of Tear trough deformity, a synergistic approach involving the concurrent use of HA injectable products and Energy-Based Devices is proposed. Such a combined intervention addresses not only volume loss but also considers aspects such as muscle mobility, fat pad herniation, and skin texture, providing predictable treatment outcomes with increased patient satisfaction.

Introduction: Introduction: Tear trough deformity (TTD), marked by infraorbital hollowing, is a common aesthetic concern tied to aging. It results from facial volume loss, causing shadowing and pigmentation beneath the eyes. While in younger individuals, TTD is often limited to the tear trough, advancing age can extend its impact to the entire under-eye area. The concave groove associated with TTD is frequently linked to herniation of superior orbital fat within lower lid fat compartments, accentuating its visibility.
Multiple factors contribute to TTD, including cheek descent, facial volume loss, suboptima

Materials / method: Recognizing the multifactorial nature of TTD, a synergistic approach involving the concurrent use of HA injectable products and Energy-Based Devices is proposed.

Results: Both modalities serve to instigate connective tissue remodelling and stimulate the synthesis of new collagen in the dermis, thereby enhancing skin elasticity and mitigating pigmentation and erythema changes. EBD utilized to treat tear trough deformity are ultrasound-based devices, monopolar RF, bipolar RF, RF with microneedling, etc. The treatment typically involves multiple sessions of EBD, complemented by 1-2 sessions of HA injectable products for optimal results.

Conclusion: This combined intervention addresses not only volume loss but also considers aspects such as muscle mobility, fat pad herniation, and skin texture. It results in faster and more predictable treatment outcomes with increased patient satisfaction.

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