Volume loss theory has changed the traditional theory of excess tissue as the cause of facial aging. Periorbital area is a challenging region for the injection because of its thin skin, increased vascularity, and compromised lymphatic drainage system. So contour irregularities, asymmetries, and Tyndall effect would be prevented if injection is performed by expert physician. The authors reported safety and patient satisfaction outcomes after using hyaluronic acid filler for correction of infraorbital hollowing. This was a retrospective observational study performed on a total of 202 eyes in 101 patients with a mean follow-up of 12 months. The average initial treatment volume was 1cc. Adverse effects include bruising 10%, contour irregularities in 2%, swelling in 3% and Tyndall effect in 1%. There was no report of vascular compromise. They used hyaluronidase in 3% of cased. They concluded that hyaluronic acid filler has a high patient satisfaction and an acceptable safety for the correction of infraorbital hollowing.

Novel use of a volumizing hyaluronic acid filler for treatment of infraorbital hollows.
Hall MB, Roy S, Buckingham ED.
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