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Treating the tear trough: A new classification system, a 6‐step evaluation procedure, hyaluronic acid injection algorithm, and treatment sequences
Author(s) -
Peng Peter HsienLi,
Peng JuiHui
Publication year - 2018
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.12514
Subject(s) - deformity , categorization , algorithm , medicine , protocol (science) , computer science , surgery , orthodontics , artificial intelligence , pathology , alternative medicine
Summary Introduction The tear trough deformity is commonly requested for correction, most often by filler injections. However, the tear trough remains difficult to treat due to its complex anatomy, a variety of other concurrent deformities, and the high risk of complications. Objectives To create a standardized categorization, evaluation, and treatment protocol for the management of tear troughs with fillers. Methods (1) Patient deformity profiles are determined using three categories of traits: A (Atrophy), B (Bulging), L (Laxity). (2) A 6‐step evaluation process (Tilt, Snap, Smile, Squint, Pull, Push) aids in ABL determination. (3) Treatment is simplified into a comprehensive protocol for each category (with 6 major injection points and a variety of injection depths and volumes). Results The author has achieved satisfactory results using the presented protocols, with photographic examples. Conclusion The author proposes a comprehensive categorization system that takes into account both the tear trough and other concurrent deformities. The author also presents 6 tests to aid in categorization, and simple protocols with injection sequences, amounts, and depth.