Skip to main content

Advertisement

Log in

Tear Trough Treatment with Orbicularis Oculi Muscle Suspension

  • Original Article
  • Oculoplastic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Blepharoplasty is a very requested surgery for aesthetic rejuvenation of the eyes with grateful results. Lower blepharoplasty involving a variety of different techniques can be considered to refresh the oculopalpebral area. The approach of the treatment of the tear trough as releasing the tear trough ligament and plication of orbicularis oculi muscle in the palpebral portion to fill the tear trough concavity is essential in our surgical technique demonstrated here.

Methods

From July 2014 to January 2020, 435 patients were submitted to blepharoplasty surgery for rejuvenation of the eyes. Lower blepharoplasty was performed with releasing of the tear trough ligament and suspension and fixation of the palpebral part of the orbicularis oculi muscle in the medial part of orbital bone corresponding to the tear trough area. The follow-up was 12 months.

Results

Patient satisfaction was high, and no complications were observed. Ten patients (2.2%) needed the addition of hyaluronic acid fillers in the tear trough 12 months after the surgery.

Conclusion

We conclude that the use of the orbicularis oculi muscle suspension improves the long-term aesthetic results for the tear trough and the technique is easy to perform.

Level of Evidence IV

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Wong CH, Mendelson B (2019) The long-term static and dynamic effects of surgical release of the tear trough ligament and origins of the orbicularis oculi in lower eyelid blepharoplasty. Plast Reconstr Surg 144:583–591

    Article  CAS  Google Scholar 

  2. Jaishree S (2012) Dermal fillers for the treatment of tear trough deformity: a review of anatomy, treatment techniques, and their outcomes. J Cutan Aesthet Surg 5(4):229–238

    Article  Google Scholar 

  3. Hashem AM, Couto RA, Duraes EFR, Çakmakoglu Ç, Swanson M, Surek C, Zins J (2020) Facelift part I: history, anatomy, and clinical assessment. Ahesthetic Surg J 40(1):1–18

    Article  Google Scholar 

  4. Wong CH, Hsieh MKH, Mendelson B (2012) The tear trough ligament: anatomical basis for the tear trough deformity. Plast Reconstr Surg 129:1392–1402

    Article  CAS  Google Scholar 

  5. Wong CH, Mendelson B (2013) Facial soft-tissue spaces and retaining ligaments of the midcheek: defining the premaxillary space. Plast Reconstr Surg 132:49–56

    Article  CAS  Google Scholar 

  6. Graf RM, Ono MCC, Armon O, Pace DHT, Balbinot P (2016) Midface lift through lower lid blepharoplasty incision. Clin Surg 1:1254

    Google Scholar 

  7. Wong CH, Mendelson B (2017) Extended transconjuntival lower eyelid blepharoplasty with release of the tear trough ligament and fat redistribution. Plast Reconstr Surg 140:273–282

    Article  CAS  Google Scholar 

  8. Chan NJ, Nazemzadeh M, Hartstein ME, Holds J, Massry GG, Wulc AE (2018) Orbicularis retaining ligament release in lower blepharoplasty: assessing efficacy and complications. Ophthalmic Plast Reconstr Surg 34(2):155–161

    Article  Google Scholar 

  9. Espinoza GM, Holds J (2007) Evaluation and treatment of the tear trough deformity in lower blepharoplasty. Semin Plast Surg 21(1):57–64

    Article  Google Scholar 

  10. Rohrich RJ, Ghavami A, Mojallal A (2011) The five-step lower blepharoplasty: blending the eyelid-cheek junction. Plast Reconstr Surg 128(3):775–783

    Article  CAS  Google Scholar 

  11. Haddock NT, Saadeh PB, Boutros S, Thorne CH (2009) The tear trough and lid/cheek junction: anatomy and implications for surgical correction. Plast Reconstr Surg 123(4):1332–1340

    Article  CAS  Google Scholar 

  12. Jehoon O, Kwon HJ, Choi YJ, Cho TH, Yang HM (2018) Three-dimensional structure of the orbicularis retaining ligament: an anatomical study using micro-computed tomography. Sci Rep 8:17042. https://doi.org/10.1038/s41598-018-35425-0

    Article  CAS  Google Scholar 

  13. Pelle-Ceravolo M, Angelini M (2020) Properly diluted fat (PDF): an easy and safe approach to periocular fat grafting. Aesthetic Surg J 40(1):19–33

    Google Scholar 

  14. Huang Z, Lee Y, Yan G, Wang K (2019) Downward rotation of the capsulopalpebral fascia, orbital septum, and orbital fat complex: a new technique for lower eyelid rejuvenation. PRS Glob Open. https://doi.org/10.1097/GOX.0000000000002335

    Article  Google Scholar 

  15. Lee JH, Hong G (2018) Definitions of groove and hollowness of the infra-orbital region and clinical treatment using soft-tissue filler. Arch Plast Surg 45:214–221

    Article  Google Scholar 

  16. Kim SK, Choi CW, Youn SW (2019) Effectiveness of transconjuntival fat removal and resected fat grafting for lower eye bag and tear trough deformity. JAMA Facial Plast Surg 21(2):118–124

    Article  Google Scholar 

  17. Choo PH, Rathbun JE (2003) Cautery of the orbital septum during blepharoplasty. Ophthal Plast Reconstr Surg 19:1–4

    Article  Google Scholar 

  18. Choi Y, Kang HG, Nam YS, Kang JG, Kim IB (2017) Facial nerve supply to the orbicularis oculi around the lower eyelid: anatomy and its clinical implications. Plast Reconstr Surg 140:261–271

    Article  CAS  Google Scholar 

  19. Rohrich RJ, Ghavami A, Mojallal A (2011) The five-step lower blepharoplasty: blending the eyelid-cheek junction. Plast Reconstr Surg 128:775–783

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ruth Graf.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (MP4 83434 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Graf, R., Pace, D. Tear Trough Treatment with Orbicularis Oculi Muscle Suspension. Aesth Plast Surg 45, 546–553 (2021). https://doi.org/10.1007/s00266-020-01922-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-020-01922-9

Keywords

Navigation