Nonsurgical lower eyelid rejuvenation using injectable poly‐<scp>d</scp>,<scp>l</scp>‐lactic acid in Asian patients
Jui‐Yu Lin, Chuan‐Yuan Lin
Abstract
BACKGROUND: Filler injection for lower eyelid rejuvenation remains a difficult subject due to many complicated anatomic changes as the face ages. OBJECTIVES: To propose an alternative, simple, and effective filler injection method in lower eyelids for Asian patients. METHODS: Any patient who has tear trough deformities, infra-orbital hollows, nasojugal grooves, dark eye circles, as well as mild eyebags is a potential candidate for this method. Our filler choice is injectable poly-d,l-lactic acid (PDLLA; AestheFill; REGEN). PDLLA must be reconstituted with sterile water for injection (SWFI) before administration. When the patient's troughs, grooves, or volume deficit are classes II and III, 3-4 ml of SWFI and 1 ml of lidocaine are used. When the deficits are class I, 5-7 ml of SWFI and 1 ml of lidocaine are used. With the fanning injection technique, a wide region that covers all the deficits is evenly injected. The depth is under the dermis layer. The total amount of filler injection is not more than 2 ml on each side. RESULTS: Since 2019, we have injected more than 100 patients by following these steps in Taiwan. The level of patient satisfaction is high. Only some mild and transient post-injection complications such as edema, erythema, and ecchymosis were found. CONCLUSIONS: We propose an alternative, simple and effective method for non-surgical lower eyelid rejuvenation for Asian patients. However, anyone who wants to perform this procedure should be well-trained and knowledgeable about the anatomy, product, and procedure to prevent adverse events.