Table 5.

Authors Recommendations for Treating Tear Trough

Recommendations

● Make the injection with the patient seated as the tear trough deformity is better visualized in this position than when the patient is lying down. ● Use low-viscosity instead of high-viscosity hyaluronic acid (HA) or non-biodegradable agents, as it can be safely injected with fewer adverse effects. ● Avoid superficial injections to prevent the Tyndall effect, a bluish discoloration under the skin that may arise when the HA is injected too superficially. ● The HA filler should be gently massaged for even distribution, yet avoiding massaging too strongly. ● Follow the key principle “less is more”, in order to prevent bulges under the eye, it is much better to undercorrect rather than overcorrect the tear trough area. ● It is essential to be cautious while injecting around the infraorbital foramen to avoid injury to the neurovascular bundle. ● Inject very slowly. ● Both a needle or a cannula can be used with good results. Nevertheless, blunt-tipped cannulas may be safer due to the reduced chance of damaging vessels and nerves. ● The patients must be informed that they ought to avoid any strong or extended pressure to the area treated.