Seminars in Plastic Surgery. 21(1):57–64, FEBRUARY 2007
PMID: 20567659
Issn Print: 1535-2188
Publication Date: February 2007
Evaluation and Treatment of the Tear Trough Deformity in Lower Blepharoplasty
Gabriela Espinoza;John Holds;
+ Author Information
1Department of Ophthalmology, 2Otolaryngology-Head and Neck Surgery, Saint Louis University, St. Louis, Missouri
Abstract
The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techniques have evolved to address this cosmetic issue including subtractive blepharoplasty techniques, elevation of ptotic eyelid and midface tissues, and the injection or implantation of autogenous or alloplastic materials to diminish its appearance. Greater anatomic understanding of the pathogenesis of the tear trough deformity has led to more anatomically conservative and appropriate cosmetic surgical treatments. The decline in purely subtractive surgical techniques in blepharoplasty surgery and the advent of fat-repositioning techniques and new subdermal fillers have improved surgical outcomes.