Innovative approach for tear trough deformity correction using higher G prime fillers for safe, efficacious, and long-lasting results: A prospective interventional study.

[BACKGROUND] One of the most challenging areas for facial rejuvenation is the lower eyelid. Apart from the protruding orbital fat causing lower lid bags, a discrete entity called the "tear trough deformity" is distinguishable in this area.

[AIM] The objective of this study is to compare and evaluate the standard technique of tear trough deformity correction with the lateral injection technique using a high G prime filler to establish a guideline for the safe and effective correction of tear trough deformity.

[METHODS] A prospective, double-blind, study was carried out from Dec 2017 to 2019 including 30 participants in the age range of 35-60 years. The participants were divided into two groups of 15 patients each. In group A patients, conventional technique with a low G Prime filler was used, whereas in group B, lateral injection technique with a high G Prime filler was used.

[RESULTS] Marked improvement was seen in appearance and skin quality on both the sides in all the patients. As compared to our technique (lateral injections) where a mean of 0.5 ml of filler was used to lift the cheek and reduce the tear trough, the standard technique (Mauricio de Maio's 3-point tear trough reshape technique) required a mean of 1.2 ml of filler for the same. Post-procedure complications including bruising and Tyndall effect were much higher (statistically significant) using the standard medial technique for the correction tear trough.

[CONCLUSION] Aesthetically satisfying results for the tear trough correction are possible, without actually injecting the tear trough directly, based on the knowledge of the underlying anatomy.