A youthful-looking eye relies on a seamless transition between the lower eyelid and the upper cheek, an area referred to as the tear trough. Age-related volume loss in this region can lead to noticeable eye bags, often exacerbated by skin laxity in the lower eyelid and puffiness caused by fluid retention.

Below are photos of a woman who received 1ml of filler in her cheeks and 0.3ml in her tear trough on each side. This combination treatment achieved a refreshed and rejuvenated appearance.

When squinting, a noticeable reduction in wrinkles around the eyes is observed following treatment. This improvement is attributed to the hydrophilic (water-absorbing) properties of hyaluronic acid filler, which provides a plumping and hydrating effect. The result is comparable to the way a balloon’s wrinkled surface smooths out as it is inflated.

The second step involved administering 20 units of anti-wrinkle injections into the frowning muscles (procerus and corrugators). Since these muscles contribute to pulling the eyebrows downward, relaxing them results in a lifted appearance and enhances the eyebrow arch.

This demonstrates how combining two relatively affordable injectable treatments can achieve results comparable to costly and invasive surgical procedures like blepharoplasty.

References: 

1. De Maio M, Rzany B. Injectable fillers in aesthetic medicine. Injectable Fillers in Aesthetic Medicine. 2014. 

2. Carruthers J, Carruthers A (2004) Aesthetic botulinum A toxin in the mid and lower face and neck. Dermatol Surg 29(5):468–476

3. Carruthers A, Carruthers J, Monheit GD, Davis PG,Tardie G (2010) Multicenter, randomized,parallel- group study of the safety and effectiveness ofonabotulinumtoxinA and hyaluronic acid dermal fillers(24-mg/ml smooth, cohesive gel) alone and in combination for lower facial rejuvenation. Dermatol Surg 36(Suppl 4):2121–2134

4. de Maio M (2003) Botulinum toxin in association with other rejuvenation methods. J Cosmet Laser Ther 5(3–4):210–212

5. de Maio M (2004) The minimal approach: an innovation in facial cosmetic procedures. Aesthetic Plast Surg 28(5):295–300 

6. Schierle CF, Casas LA (2011) Nonsurgical rejuvenation of the aging face with injectable poly-L-lactic acid for restoration of soft tissue volume. Aesthet Surg J 31(1):95–109