title: Estimation of bony orbit depth for optimal selection of the injection technique to correct the tear trough and palpebromalar groove.
abstract: BACKGROUND
  Different techniques have been used for filler injection of the tear trough and palpebromalar groove. Most patients report good results; however, some patients here experienced variable degrees of side effects.
  
  
  OBJECTIVE
  To assess if previous estimation of the bony orbit depth could affect the choice between bolus and serial puncture technique, and thereby the procedure outcome.
  
  
  METHODS
  In 32 patients, the periosteum depth was measured by using a 28 G needle at 2 points: Point A at the midpupillary line and Point B at the outer canthus. The bolus technique was performed in the right side, and serial puncture technique was done on the left side.
  
  
  RESULTS
  There was a significant difference in the degree of improvement between both sides in 71% of patients: 40% had better improvement on the right side, whereas 31% had better improvement on the left side. Cases with skin-to-periosteum depth less than 0.5 cm showed better results with serial puncture technique, whereas those with more than 0.5 cm depth showed better results with bolus technique.
  
  
  CONCLUSIONS
  Assessment of bony orbit depth could offer new tool for selecting infraorbital groove injection technique.
authors.affiliation: Department of Dermatology and Andrology, Alexandria University, Alexandria, Egypt.
authors.forename: Yehia Farouk
authors.initials: YF
authors.lastname: El-Garem
mesh_terms: D000328:Adult; D002610:Cheek; D003357:Cosmetic Techniques; D003879:Dermatologic Agents / Q000008:administration & dosage*; D005143:Eyelids; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007279:Injections, Subcutaneous / Q000379:methods; D008875:Middle Aged; D009915:Orbit / Q000033:anatomy & histology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D015595:Skin Aging; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D006820:Hyaluronic Acid