Definition of the tear trough and the tear trough rating scale.
BACKGROUND
Nasojugal groove and tear trough are interchangeably used terms by many authors in the literature despite the fact that they describe distinct and different anatomic entities. In the same vein, there are multiple descriptions of treatments and techniques for the cosmetic improvement of these anatomic areas without specifically addressing the anatomic difference between them.


OBJECTIVE
This study aims to define the anatomic characteristics of the tear trough and describe a novel classification scale for the evaluation of the tear trough deformity.


METHODS
The tear trough rating scale (TTRS) was applied to a representative sample of our patient population. Five of the authors evaluated each patient using the TTRS, and the numeric results were tabulated and compared. Results The TTRS provided an effective, reproducible method for evaluating tear trough deformities, and there was very little interobserver variability.


CONCLUSIONS
The tear trough should be defined as the depression of the medial lower eyelid just lateral to the anterior lacrimal crest and limited in its inferior aspect by the inferior orbital rim. The TTRS is a reliable tool for the classification of the tear trough and evaluation of therapeutic and cosmetic interventions.
Weill Medical College, Cornell University, New York, NY 10021, USA. nssderm@sadickdermatology.com
Neil S
NS
Sadick
Stephen L
SL
Bosniak
Marian
M
Cantisano-Zilkha
Ioannis P
IP
Glavas
Deborshi
D
Roy
D000328:Adult; D019882:Blepharoplasty; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus; D008875:Middle Aged; D015361:Rhytidoplasty; D012720:Severity of Illness Index; D015595:Skin Aging