Under-Eye Rejuvenation and Mid-Face Support: A Case Study and Efficacy Assessment Using Tear Trough Fillers
In the field of facial rejuvenation, comprehensive improvement of the under-eye area has always been a core concern for aesthetic physicians and patients. Bags under the eyes, tear troughs, malar folds, and sagging cheeks—these four signs of aging often intertwine, profoundly impacting the overall mid-facial contour and youthful appearance. Among these, tear trough hollowing is particularly prominent; the resulting shadows and visual fatigue are key factors contributing to an aged appearance. This article will delve into a specific tear trough HA filler case study, analyzing how tear trough filling can synergistically achieveunder-eye rejuvenationand mid-face support, and assess the long-term efficacy of hyaluronic acid fillers, aiming to provide a reference for clinical practice.
Anatomical and Aesthetic Challenges of Tear Troughs
Tear troughs refer specifically to the depressions formed by the atrophy and sagging of soft tissue at the lower edge of the orbital septum.Their anatomical location typically begins at the inner corner of the eye, extending downwards along the orbital rim to the area between the cheekbone and the nasal ala, often lower than the position of eye bags. Their appearance signifies weakening of the periorbital support structures, loss of subcutaneous tissue, and the beginning of bone resorption. This not only deepens the illusion of "dark circles" but also disrupts the smoothness and continuity of the mid-face through light and shadow contrast.
Simply removing eye bags without correcting tear troughs often fails to achieve ideal rejuvenation results. Therefore, the core of an under-eye filler strategy lies in precise assessment: differentiating between pseudo-eye bags (which are actually tear trough depressions) and true eye bags, and determining whether there is accompanying mid-face volume loss and ligament laxity (such as Indian lines and sagging cheeks). A successful tear trough filler treatment should go beyond local filling, focusing on reconstructing the natural transition of the mid-to-lower face and restoring mid-face contour support.
Case Study: Detailed Analysis of a Tear Trough Hyaluronic Acid Filler Case
This tear trough hyaluronic acid case study involves a 42-year-old female patient whose primary concern was improving her severely tired-looking appearance. Clinical assessment revealed: significant bilateral tear trough depressions (moderate), accompanied by mild volume loss in the lower eyelids and early flattening of the malar area, with the initial appearance of nasolabial folds. Skin texture was fair, with no significant laxity.
The treatment goals were set as follows:
1) Safely and effectively fill the tear troughs to eliminate the sunken shadows;
2) Achieve a mild lifting and supporting effect through micro-injections at key points in the mid-face, indirectly improving the appearance of nasolabial folds;
3) Restore a smooth transition between the lower eyelid and cheek area
Treatment Plan and Material Selection: After thorough discussion, a biphasic cross-linked hyaluronic acid filler with high cohesiveness, moderate viscoelasticity, and good supporting capacity was selected. This type of product is more suitable for precise filling on the periosteum or in deeper layers due to its rheological properties, providing stable volume support while reducing the risk of the Tyndall effect.
Efficacy Evaluation and Durability Observation
Immediate and Short-Term Effects (1-2 weeks post-procedure): Immediately after the procedure, the tear trough depression was significantly improved, under-eye shadows were reduced, and the visual appearance of fatigue was greatly diminished. Mild swelling subsided within 3-5 days. At the one-week follow-up, the results were natural, and the patients expressed satisfaction with the smoothness of the lower eyelid area and the overall "lifting effect" of the mid-face. Due to accurate injection depth and conservative dosage, no complications such as bruising, nodules, or unevenness occurred.
Medium-Term Effects (3-12 months post-procedure): Follow-ups at 3, 6, and 12 months showed that the filling effect remained stable. Data from this tear trough hyaluronic acid filler case study showed that patient satisfaction remained consistently high during this period. The injected hyaluronic acid integrated well with the tissue, providing not only physical support but also improving local skin texture through its hydrating effect. The mild supporting effect on the mid-face made the nasolabial folds appear softer, and the visual position of the cheekbones was improved.
Long-Term Durability Assessment (18-24 months post-procedure): At 18 months post-procedure, although some of the filling effect had metabolized, the tear trough area still maintained a significantly improved state compared to before treatment, and the overall contour "memory" was preserved. By 24 months, the main supporting effect had weakened, but it was still superior to the baseline level. This durability is attributed to:
1. Precise deep injection: Subperiosteal/deep layer filling has a relatively slower metabolic rate.
2. Biostimulatory effect: Certain highly elastic hyaluronic acid fillers can gently stimulate surrounding collagen regeneration, forming an internal support network and extending the duration of the effect.
3. Comprehensive aesthetic design: The synergistic support of the mid-face breaks the local aging chain, making the overall improvement more meaningful in terms of "anti-aging."
Comparison and Implications: Compared to simple superficial filling, this combined strategy focusing on deep support and mid-face transition demonstrates significant advantages in terms of efficacy, durability, and naturalness. This tear trough hyaluronic acid case also confirms the effectiveness of the modern injection concept of "small amounts, deep injection, and multi-point support."
Extended Discussion on Tear Trough Filling: Comparison with Other Materials and Methods
Although hyaluronic acid is currently the mainstream choice for tear trough filling, other materials such as collagen also have their applications. Collagen has biological characteristics similar to the human body, possesses high biocompatibility, is easier to shape, and can stimulate the regeneration of endogenous collagen, offering additional benefits in improving skin laxity and fine lines. However, its main drawback is the lack of immediate and significant filling effect, and its irreversibility. For tear troughs primarily characterized by volume loss and requiring immediate smoothing effects, hyaluronic acid remains the preferred under-eye filler due to its predictable and reversible effects, allowing for precise adjustments by the physician.
For complex tear troughs accompanied by severe skin laxity or true eye bags, combination therapy is a better option. This may involve combining it with radiofrequency skin tightening to improve skin elasticity, or using orbital septum release surgery to reposition eye bag fat to fill the tear trough, achieving two goals at once. In this case, since the patient's skin firmness was still acceptable, a single hyaluronic acid injection achieved the desired results.
Conclusion
This case study on under-eye rejuvenation demonstrates that a combined strategy, centered on deep, precise hyaluronic acid filler injection into the tear trough, supplemented with micro-injections at key points in the mid-face, is a safe and reliable method for effectively achieving under-eye rejuvenation and mid-face contour reshaping. Through rigorous analysis of this tear trough HA filler case study, it was confirmed that this approach not only provides immediate and natural correction of tear trough hollowing but also offers long-lasting improvement for 18-24 months by providing deep support, indirectly optimizing the appearance of nasolabial folds and the apple cheek area.
Successful tear trough filling is far more than simply filling in a hollow; it is a comprehensive art requiring profound anatomical knowledge, precise injection techniques, and a holistic aesthetic vision. Doctors must accurately assess each patient's individual differences, select appropriate filler products, carefully administer the correct dosage at the correct depth, and always prioritize safety, natural results, and long-term effects to truly achieve a transformative rejuvenation.
