Abstract：
BACKGROUND: Fillers are popular substances for the correction of tear trough deformity. Despite well-documented complications increasing gradually, standardized treatment algorithm for deformity secondary to improper injection is still limited.
METHODS: Between April 2020 and April 2023, a total of 22 patients with filler-associated tear trough deformity with static bulges or dynamic swells after injection of tear trough were enrolled. For patients who received hyaluronic acid (HA) and unknown fillers, hyaluronidase dissolution was performed. For patients who received non-HA fillers and unknown fillers that failed to dissolve, a magnetic resonance imaging (MRI) examination was conducted. Surgical approaches were selected based on the filler distribution and the condition of the lower eyelid. Ligament releasement and fat transposition were accomplished when fillers were excised. Aesthetic outcomes were evaluated by double-blind examiners using the Global Aesthetic Improvement Scale after patients were followed up.
RESULTS: In total, the study included 3 patients with simple static deformities, 1 patient with simple dynamic, and 18 patients with both. Fourteen patients underwent transconjunctival surgery and 8 patients underwent transcutaneous surgery, among which 18 patients underwent hyaluronidase dissolution and 8 patients underwent MRI prior to surgery. A total of 4 patients with self-limited complications recovered after conservative treatment. 90.9% of patients expressed satisfaction or high satisfaction with the treatment results.
CONCLUSIONS: Filler-associated tear trough deformities could be classified into static and dynamic deformities, which could appear separately or simultaneously. Treatment of deformities should be based on characteristics of fillers, in which MRI could serve as a promising tool.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
METHODS: Between April 2020 and April 2023, a total of 22 patients with filler-associated tear trough deformity with static bulges or dynamic swells after injection of tear trough were enrolled. For patients who received hyaluronic acid (HA) and unknown fillers, hyaluronidase dissolution was performed. For patients who received non-HA fillers and unknown fillers that failed to dissolve, a magnetic resonance imaging (MRI) examination was conducted. Surgical approaches were selected based on the filler distribution and the condition of the lower eyelid. Ligament releasement and fat transposition were accomplished when fillers were excised. Aesthetic outcomes were evaluated by double-blind examiners using the Global Aesthetic Improvement Scale after patients were followed up.
RESULTS: In total, the study included 3 patients with simple static deformities, 1 patient with simple dynamic, and 18 patients with both. Fourteen patients underwent transconjunctival surgery and 8 patients underwent transcutaneous surgery, among which 18 patients underwent hyaluronidase dissolution and 8 patients underwent MRI prior to surgery. A total of 4 patients with self-limited complications recovered after conservative treatment. 90.9% of patients expressed satisfaction or high satisfaction with the treatment results.
CONCLUSIONS: Filler-associated tear trough deformities could be classified into static and dynamic deformities, which could appear separately or simultaneously. Treatment of deformities should be based on characteristics of fillers, in which MRI could serve as a promising tool.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
摘要：
背景：填充剂是用于矫正泪槽畸形的常用物质。尽管有据可查的并发症逐渐增加，注射不当继发畸形的标准化治疗算法仍然有限。
方法：在2020年4月至2023年4月之间，共纳入22例填充剂相关泪槽畸形患者，在注射泪槽后出现静态凸起或动态肿胀。对于接受透明质酸（HA）和未知填充剂的患者，进行透明质酸酶溶解。对于接受非HA填充剂和未知填充剂无法溶解的患者，进行了磁共振成像(MRI)检查.根据填充物的分布和下眼睑的状况选择手术方法。切除填充剂时，完成了韧带释放和脂肪转座。患者随访后，双盲检查者使用全球美学改善量表评估美学结局。
结果：总计，该研究包括3例单纯静态畸形患者，1名患者具有简单的动态，和18名患者。14例患者接受了经结膜手术，8例患者接受了经皮手术，其中18例患者接受了透明质酸酶溶解,8例患者在手术前接受了MRI检查.共有4例出现自限性并发症的患者经保守治疗后恢复。90.9%的患者对治疗结果表示满意或高度满意。
结论：填料相关泪槽畸形可分为静态和动态畸形，可以单独或同时出现。畸形的治疗应基于填料的特性，MRI可以作为一种有前途的工具。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：在2020年4月至2023年4月之间，共纳入22例填充剂相关泪槽畸形患者，在注射泪槽后出现静态凸起或动态肿胀。对于接受透明质酸（HA）和未知填充剂的患者，进行透明质酸酶溶解。对于接受非HA填充剂和未知填充剂无法溶解的患者，进行了磁共振成像(MRI)检查.根据填充物的分布和下眼睑的状况选择手术方法。切除填充剂时，完成了韧带释放和脂肪转座。患者随访后，双盲检查者使用全球美学改善量表评估美学结局。
结果：总计，该研究包括3例单纯静态畸形患者，1名患者具有简单的动态，和18名患者。14例患者接受了经结膜手术，8例患者接受了经皮手术，其中18例患者接受了透明质酸酶溶解,8例患者在手术前接受了MRI检查.共有4例出现自限性并发症的患者经保守治疗后恢复。90.9%的患者对治疗结果表示满意或高度满意。
结论：填料相关泪槽畸形可分为静态和动态畸形，可以单独或同时出现。畸形的治疗应基于填料的特性，MRI可以作为一种有前途的工具。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
