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Measuring bony orbit depth helped determine best filler technique

Assessment of the bony orbit depth can help determine the best technique for filler injection of the tear trough and the palpebromalar groove, according to recently published study results.

Yehia Farouk El-Garem, MD, measured the periosteum depth by using a 28-G needle at two points, with point A at the midpupillary line and point B at the outer canthus, in 32 women who met the criteria of having nearly identical depths of needle penetration at points A and B in both eyes. A hyaluronic acid filler was injected into the right side using the bolus technique, and a serial puncture technique was used for the injection on the left side.

Twenty-three of the patients (71%) had a significant difference in degree of improvement between both sides, according to the researchers. Thirteen patients displayed better improvement on the right side, whereas 10 had better improvement on the left side.

The bolus injection technique used more filler material (a 0.2-mL to 0.5-mL difference) than the serial puncture injection technique, even when the injection depths were the same on each side.

“Cases with skin-to-periosteum depth less than 0.5 cm showed better results with serial puncture technique, whereas those with more than 0.5 cm depth showed better results with bolus technique,” El-Garem wrote.

Skin-to-periosteum distance should be used to determine the optimal technique, he concluded.

Disclosure: The author has no relevant financial disclosures.