title: Anatomical position of hyaluronic Acid gel following injection to the infraorbital hollows.
abstract: OBJECTIVE
  To examine with histology the anatomical location of hyaluronic acid gel injected to the infraorbital hollows of cadaver specimens.
  
  
  METHODS
  The authors dissected 5 fresh hemifacial cadaver specimens following preperiosteal injection of hyaluronic acid gel to the infraorbital hollows. Following tissue fixation, full-thickness soft tissue sections were obtained along the medial, central, and lateral lower eyelid/midface of each specimen. Histologic examination of the anatomical location of hyaluronic acid gel was performed using hematoxylin and eosin and Hale colloidal iron stains.
  
  
  RESULTS
  Histologic examination of the central and lateral lower eyelid/midface sections revealed a significant portion of hyaluronic acid gel in either a postorbicularis or a subcutaneous plane in 8 of 10 sections. Only 2 sections displayed hyaluronic acid gel solely within a preperiosteal plane. The medial sections revealed hyaluronic acid gel resting in either a preperiosteal or an intraorbicularis plane. Soft tissue structures such as deep fat compartment septa and the orbicularis oculi muscle appeared to play a significant role in influencing the resting position of hyaluronic acid gel.
  
  
  CONCLUSIONS
  In most specimens, the location of a significant portion of hyaluronic acid gel following injection to the infraorbital hollows differed from the intended injection plane. Soft tissue structures including fat compartment septa and the orbicularis oculi muscle appear to influence the resting position of hyaluronic acid gel. Careful attention should be used to avoid overfilling the thin soft tissue layers of the medial infraorbital hollows or tear trough.
authors.affiliation: Oculoplastic, Facial Cosmetic, and Orbital Surgery, University of Wisconsin-Madison, Madison, WI 53226, USA. gjgriepe@hotmail.com
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Griepentrog
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Lemke
authors.forename: Cat N
authors.initials: CN
authors.lastname: Burkat
authors.forename: John G
authors.initials: JG
authors.lastname: Rose
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Lucarelli
mesh_terms: D001672:Biocompatible Materials / Q000008:administration & dosage; D002102:Cadaver; D003357:Cosmetic Techniques; D005143:Eyelids / Q000187:drug effects* / Q000473:pathology; D005152:Facial Muscles / Q000187:drug effects / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007271:Injections, Intradermal; D009801:Oculomotor Muscles / Q000187:drug effects / Q000473:pathology; D009915:Orbit / Q000187:drug effects* / Q000473:pathology; D015361:Rhytidoplasty; D015595:Skin Aging; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D001672:Biocompatible Materials; C526061:Juvederm Ultra; D055675:Viscosupplements; D006820:Hyaluronic Acid