Esthetic approach to the lower eyelid - A review of the main therapeutic options

Authors

DOI:

https://doi.org/10.33448/rsd-v10i5.15033

Keywords:

Tear trough; Aesthetic approach; Lower eyelid.

Abstract

Introduction: Changes in the tear through and infraorbital region are one of the first recognizable signs of aging. These are common complaints in aesthetic medicine and there are many treatment options available. With this in mind, the purpose of this study is to perform a literature review to describe the anatomy and changes in the infraorbital region due to aging and present the main therapeutic options for each case. Materials and methods: A simple literature review was performed in the databases: Pubmed, Scielo, Web of Sciences, using the descriptors: Tear trough, Infraorbital, Dark-circles, Lower-Eyelid, Hyperpigmentation and Midface, treatment, therapeutics with their corresponding terms in English and Portuguese. Results: Fillers, collagen biostimulators, lasers, radiofrequency devices, microagulants, chemical peels, cosmeceuticals and botulinum toxin are available non-surgical treatment options discussed in the literature, it was found to significantly improve and rejuvenate the infraorbital region.  Conclusion: A thorough understanding of the anatomy and changes that occur with aging are of utmost importance in evaluating the infraorbital region to determine appropriate treatment options as a way to achieve optimal rejuvenation.

Author Biography

André Borba, Universidade de São Paulo

Doutor em Ciências Médicas pela Universidade de São Paulo (USP)
Fellowship em Oculoplástica no Jules Stein Eye Institute (UCLA), Los Angeles | Califórnia (EUA)

Pós-graduado em Medicina Estética pela Associação Internacional de Medicina Estética (ASIME)

Membro titular da Comissão Científica do Conselho Brasileiro de Oftalmologia (CBO) Membro titular das Sociedades Brasileira e Pan-Americana de Cirurgia Plástica Ocular

Membro internacional da European Society of Ophthalmic Plastic
and Reconstructive Surgery (ESOPRS) e American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)

References

Ahmed, N. A., Mohammed, S. S., & Fatani, M. I. (2019). Treatment of periorbital dark circles: Comparative study of carboxy therapy vs chemical peeling vs mesotherapy. Journal of Cosmetic Dermatology, 18(1). https://doi.org/10.1111/jocd.12536

Al-Shami, S. (2014). Treatment of Periorbital Hyperpigmentation Using Platelet-Rich Plasma Injections. American Journal of Dermatology and Venereology, 3(5).

Alster, T. S., & Lupton, J. R. (2007). Nonablative cutaneous remodeling using radiofrequency devices. Clinics in Dermatology, 25(5). https://doi.org/10.1016/j.clindermatol.2007.05.005

Anastassov, G. E., & St. Hilaire, H. (2006). Periorbital and midfacial rejuvenation via blepharoplasty and sub-periosteal midface rhytidectomy. International Journal of Oral and Maxillofacial Surgery, 35(4). https://doi.org/10.1016/j.ijom.2005.09.013

Angres, G. G. (1985). The Angres Permalid-Liner method to enhance the result of cosmetic blepharoplasty. Annals of Ophthalmology, 17(3).

Bagci, B. (2018). A New Technique for the Correction of Tear Trough Deformity via Filler Injections. Plastic and Reconstructive Surgery - Global Open, 6(8). https://doi.org/10.1097/gox.0000000000001901

Barbarino, S. C. (2020). Combination Approach to Tear Trough Deformities and Under Eye Appearance Using Microfocused Ultrasound With Visualization and Hyaluronic Acid Filler. The American Journal of Cosmetic Surgery. https://doi.org/10.1177/0748806820947580

Corduff, N. (2020). An Alternative Periorbital Treatment Option Using Calcium Hydroxyapatite for Hyperpigmentation Associated with the Tear Trough Deformity. Plastic and Reconstructive Surgery - Global Open, 8(2), 1–7. https://doi.org/10.1097/GOX.0000000000002633

Couch, S. M., & Holds, J. B. (2013). Lower eyelid blepharoplasty with fat repositioning. In Midfacial Rejuvenation. https://doi.org/10.1007/978-1-4614-1007-2_15

de Maio, M. (2020). MD CodesTM: A Methodological Approach to Facial Aesthetic Treatment with Injectable Hyaluronic Acid Fillers. Aesthetic Plastic Surgery. https://doi.org/10.1007/s00266-020-01762-7

Evans, A. G., Ivanic, M. G., Botros, M. A., Pope, R. W., Halle, B. R., Glassman, G. E., Genova, R., & Al Kassis, S. (2021). Rejuvenating the periorbital area using platelet-rich plasma: a systematic review and meta-analysis. Archives of Dermatological Research. https://doi.org/10.1007/s00403-020-02173-z

Freitag, F. M., & Cestari, T. F. (2007). What causes dark circles under the eyes? In Journal of Cosmetic Dermatology (Vol. 6, Issue 3). https://doi.org/10.1111/j.1473-2165.2007.00324.x

Gendler, E. C. (2005). Treatment of periorbital hyperpigmentation. Aesthetic Surgery Journal, 25(6). https://doi.org/10.1016/j.asj.2005.09.018

Hill, R. H., Czyz, C. N., Kandapalli, S., Zhang-Nunes, S. X., Cahill, K. V., Wulc, A. E., & Foster, J. A. (2015). Evolving Minimally Invasive Techniques for Tear Trough Enhancement. Ophthalmic Plastic and Reconstructive Surgery, 31(4). https://doi.org/10.1097/IOP.0000000000000325

Hussain, S. N., Mangal, S., & Goodman, G. J. (2019). The Tick technique: A method to simplify and quantify treatment of the tear trough region. Journal of Cosmetic Dermatology, 18(6). https://doi.org/10.1111/jocd.13169

Jiang, J., Wang, X., Chen, R., Xia, X., Sun, S., & Hu, K. (2016). Tear trough deformity: Different types of anatomy and treatment options. Postepy Dermatologii i Alergologii, 33(4). https://doi.org/10.5114/ada.2016.61607

Jones, D. H., Kenkel, J. M., Fagien, S., Glaser, D. A., Monheit, G. D., Stauffer, K., & Sykes, J. M. (2016). Proper technique for administration of ATX-101 (Deoxycholic Acid Injection): Insights from an injection practicum and roundtable discussion. Dermatologic Surgery, 42. https://doi.org/10.1097/DSS.0000000000000875

Kim, J. S., Blizzard, S., Woodward, J. A., Leyngold, I. M., Liss, J., & Freedman, S. F. (2020). Prostaglandin-Associated Periorbitopathy in Children and Young Adults with Glaucoma. Ophthalmology. Glaucoma, 3(4). https://doi.org/10.1016/j.ogla.2020.03.009

Kontochristopoulos, G., Kouris, A., Platsidaki, E., Markantoni, V., Gerodimou, M., & Antoniou, C. (2016). Combination of microneedling and 10% trichloroacetic acid peels in the management of infraorbital dark circles. Journal of Cosmetic and Laser Therapy, 18(5). https://doi.org/10.3109/14764172.2016.1157363

Kounidas, G., Kastora, S., & Rajpara, S. (2020). Decoding infraorbital dark circles with lasers and fillers. Journal of Dermatological Treatment. https://doi.org/10.1080/09546634.2020.1855297

Lee, J. H., & Hong, G. (2018). Definitions of groove and hollowness of the infraorbital region and clinical treatment using soft-tissue filler. In Archives of Plastic Surgery (Vol. 45, Issue 3). https://doi.org/10.5999/aps.2017.01193

Lee, S., & Yen, M. T. (2017). Nonsurgical Rejuvenation of the Eyelids with Hyaluronic Acid Gel Injections. Seminars in Plastic Surgery, 31(1). https://doi.org/10.1055/s-0037-1598189

Lipp, M., & Weiss, E. (2019). Nonsurgical Treatments for Infraorbital Rejuvenation: A Review. In Dermatologic Surgery (Vol. 45, Issue 5). https://doi.org/10.1097/DSS.0000000000001897

Luo, S., Zhang, X., Dong, H., Wen, C., & Hao, L. (2020). Correction of the Tear Trough Deformity and Concomitant Infraorbital Hollows With Extracellular Matrix/Stromal Vascular Fraction Gel. Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.], 46(12). https://doi.org/10.1097/DSS.0000000000002359

Mac-Mary, S., Zornoza Solinis, I., Predine, O., Jean-Marie, S., Sladen, C., Bell, M., & O’Mahony, M. (2019). Identification of three key factors contributing to the aetiology of dark circles by clinical and instrumental assessments of the infraorbital region. Clinical, Cosmetic and Investigational Dermatology, 12. https://doi.org/10.2147/CCID.S217956

Môle, B. (2018). Técnicas adyuvantes de rejuvenecimiento facial. EMC - Cirugía Plástica Reparadora y Estética, 26(1). https://doi.org/10.1016/s1634-2143(18)89903-4

Montes, J. R. (2012). Volumetric considerations for lower eyelid and midface rejuvenation. In Current Opinion in Ophthalmology (Vol. 23, Issue 5). https://doi.org/10.1097/ICU.0b013e3283560ab5

Park, kui young. (2017). Hyaluronic acid filler combining with antioxidants for infraorbital rejuvenation: Report of two cases. Journal of the American Academy of Dermatology, 76(6), AB159. https://doi.org/10.1016/j.jaad.2017.04.619

Park, K. Y., Kwon, H. J., Youn, C. S., Seo, S. J., & Kim, M. N. (2018). Treatments of infra-orbital dark circles by various etiologies. In Annals of Dermatology (Vol. 30, Issue 5). https://doi.org/10.5021/ad.2018.30.5.522

Park, S. R., Kim, H. J., Park, H. K., Kim, J. Y., Kim, N. S., Byun, K. S., Moon, T. K., Byun, J. W., Moon, J. H., & Choi, G. S. (2016). Classification by causes of dark circles and appropriate evaluation method of dark circles. Skin Research and Technology, 22(3). https://doi.org/10.1111/srt.12258

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Método Qualitativo, Quantitativo ou Quali-Quanti. In Metodologia da Pesquisa Científica. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1. Acesso em: 28 março 2020.

Peng, P. H. L., & Peng, J. H. (2018). Treating the tear trough: A new classification system, a 6-step evaluation procedure, hyaluronic acid injection algorithm, and treatment sequences. Journal of Cosmetic Dermatology, 17(3). https://doi.org/10.1111/jocd.12514

Roh, M. R., & Chung, K. Y. (2009). Infraorbital dark circles: Definition, causes, and treatment options. In Dermatologic Surgery (Vol. 35, Issue 8). https://doi.org/10.1111/j.1524-4725.2009.01213.x

Ruiz-Esparza, J. (2004). Noninvasive Lower Eyelid Blepharoplasty: A New Technique Using Nonablative Radiofrequency on Periorbital Skin. Dermatologic Surgery, 30(2 I). https://doi.org/10.1111/j.1524-4725.2004.30052.x

Sarkar, R., Ranjan, R., Garg, S., Garg, V. K., Sonthalia, S., & Bansal, S. (2016). Periorbital hyperpigmentation: A comprehensive review. Journal of Clinical and Aesthetic Dermatology, 9(1).

Sawant, O., & Khan, T. (2020). Management of periorbital hyperpigmentation: An overview of nature-based agents and alternative approaches. In Dermatologic Therapy (Vol. 33, Issue 4). https://doi.org/10.1111/dth.13717

Shah-Desai, S., & Joganathan, V. (2020). Novel technique of non-surgical rejuvenation of infraorbital dark circles. Journal of Cosmetic Dermatology. https://doi.org/10.1111/jocd.13705

Sheth, P., Shah, H., & Dave, J. (2014). Periorbital hyperpigmentation: A study of its prevalence, common causative factors and its association with personal habits and other disorders. Indian Journal of Dermatology, 59(2). https://doi.org/10.4103/0019-5154.127675

Vrcek, I., Ozgur, O., & Nakra, T. (2016). Infraorbital dark circles: A review of the pathogenesis, evaluation and treatment. Journal of Cutaneous and Aesthetic Surgery, 9(2). https://doi.org/10.4103/0974-2077.184046

Wong, C. H., Hsieh, M. K. H., & Mendelson, B. (2012). The tear trough ligament: Anatomical basis for the tear trough deformity. Plastic and Reconstructive Surgery, 129(6). https://doi.org/10.1097/PRS.0b013e31824ecd77

Wong, C. H., & Mendelson, B. (2017). Extended transconjunctival lower eyelid blepharoplasty with release of the tear trough ligament and fat redistribution. Plastic and Reconstructive Surgery, 140(2). https://doi.org/10.1097/PRS.0000000000003561

Wulkan, A. J., Fabi, S. G., & Green, J. B. (2016). Microfocused Ultrasound for Facial Photorejuvenation: A Review. Facial Plastic Surgery, 32(3). https://doi.org/10.1055/s-0036-1584129

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Published

07/05/2021

How to Cite

DIAS, G. D. R. .; BORBA, A. Esthetic approach to the lower eyelid - A review of the main therapeutic options. Research, Society and Development, [S. l.], v. 10, n. 5, p. e28710515033, 2021. DOI: 10.33448/rsd-v10i5.15033. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/15033. Acesso em: 19 apr. 2024.

Issue

Vol. 10 No. 5

Section

Health Sciences

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Copyright (c) 2021 Gilmasa Daniele Rios Dias; André Borba

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