title: Quantitative evaluation of volume augmentation in the tear trough with a hyaluronic Acid-based filler: a three-dimensional analysis.
abstract: BACKGROUND
  Despite the prevalent use of hyaluronic acid-based filling materials for facial soft-tissue augmentation and favorable reports of durability in the infraorbital region, no quantitative data exist on the long-term durability of these products following injection. This study represents the first attempt to use three-dimensional imaging to quantify augmentation achieved and duration of effect with one hyaluronic acid product in the tear trough.
  
  
  METHODS
  The authors conducted a prospective, blinded case series in a clinical setting. One non-animal stabilized hyaluronic acid material was used to augment 20 tear troughs to address cosmetic deficiency in this region. Patients were followed long term with three-dimensional imaging. Posttreatment and pretreatment images were compared, volume change was calculated at each time point, and percentage change between immediate and long-term posttreatment was evaluated. All measurements and calculations were performed independent of the injector.
  
  
  RESULTS
  Residual effect from the hyaluronic acid product was demonstrable on three-dimensional imaging in 100 percent of tear troughs augmented in this study at the final follow-up visit. Average follow-up was 14.4 months (range, 8.5 to 22.75 months). Average initial augmentation measured by three-dimensional imaging was 0.21 cc per site. Average maintenance of effect for patients at the final follow-up visit was 85 percent.
  
  
  CONCLUSIONS
  The long-term durability of a small gel particle-based hyaluronic acid in the tear trough is substantiated for the first time in an objective, quantitative fashion using three-dimensional imaging for evaluation of volumetric facial rejuvenation. Three-dimensional photographic imaging offers clinicians a precise and expeditious method for quantitatively evaluating volumetric changes in the face, and represents a significant advance in technology for studying the effects of facial aging.
authors.affiliation: Cincinnati, Ohio; Highland Park and Piscataway, N.J.; and Jacksonville, Fla. From Cincinnati Facial Plastic Surgery; Glasgold Group Plastic Surgery; the Department of Surgery, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School; and Meier Plastic Surgery.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Donath
authors.forename: Robert A
authors.initials: RA
authors.lastname: Glasgold
authors.forename: Jason
authors.initials: J
authors.lastname: Meier
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Glasgold
mesh_terms: D001672:Biocompatible Materials; D002610:Cheek / Q000033:anatomy & histology; D003357:Cosmetic Techniques; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D021621:Imaging, Three-Dimensional; D007267:Injections; D009915:Orbit / Q000033:anatomy & histology*; D011446:Prospective Studies; D012060:Rejuvenation
chemical_list: D001672:Biocompatible Materials; D006820:Hyaluronic Acid