Table 1.

Structural characteristics that contribute to the appearance of the tear trough deformity

Skin	Loss of volume Reduction in the amount of collagen Distortion of elastin fibers and decrease in their elasticity
Fat	Thinning and descent of facial fat pads Redistribution, accumulation, and atrophy of the fat, which leads to loss of facial volume Dilation of dermal vessels
Musculature	The contraction of the orbicularis oculi muscle contributes to the appearance of wrinkles in fine skin. Laxity of the orbicularis oculi muscle Hyperlaxity of the orbitomalar muscle ligament
Bone	Widened orbits: receding of the inferior orbital rim