Abstract
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Introduction: The anatomy of the under eye region is complex and complications are frequently associated with treating tear trough deformity. There is a need to simplify the treatment method and to make the injection technique safe and user friendly with the least possible rate of complication and better outcomes. This will encourage more novice aesthetic physicians to address this frequent aesthetic concern of this region with confidence
Materials and methods: A total of 150 patients with different grades of tear trough deformity were injected with a total of three boluses at three divided anatomical regions of tear trough but varying amount with a simplified the Tick® technique. Irrespective of grade and quantity injected all boluses were deep supraperiostal beneath orbicularis oculi muscle. Patients photographs before and after were reviewed to assess the outcome.
Results: This simplified approach of injection technique showed considerable improvement in GAI score with minimum complications. It proved better in to conventional methods of tear trough treatment with either canulla or needle provided by the manufacture with hyalurinic acid fillers.
Discussion: In the recent times, there has been a surge in the nonsurgical treatment of the tear trough using hyaluronic acid fillers as an easy, safe and quick procedure. However, this area is dogged with adverse effects that well are documented in the literature. None of our patients presented with Tyndall effect or lumps/bumps as compared to 14% and 33% reported by Berros et al and Morley et al respectively. The incidence of localized bruising 2% was lower in comparison with 11.3% and 27% reported by Berguiga M et al and Mustak H et al. Twelve of our patients developed a localized swelling, comparable with the study by Berguiga M et al. GIA score of exceptional improvement and very improved post treatment of approx. 90% and 91% rated by doctor and subjects respectively was compatible with a study conducted by Berguiga M et al on 151 patients thereby justifying the Tick® technique. In addition another benefit with Tick technique is the comfort of procedure making it almost painless with no downtime.
In spite of the complexity of the anatomy of the periorbital area and the associated risk of complications with the treatment, all our patients improved considerably with a very low rate of adverse events. We thus put forward this novel technique for treating the tear trough and expect this would help the more novice practititioners to treat this indication confidently with a lower rate of complications and better patient satisfaction.
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