Precision Supraperiosteal Microdroplet Cannula Technique for Tear Trough Rejuvenation: A Case Series of 20 Patients
Keywords:
Tear trough, Hyaluronic acid filler, Cannula technique, Microdroplet technique, Periorbital rejuvenationAbstract
Background: Tear trough deformity produces a fatigued appearance due to shadowing along the nasojugal groove. Hyaluronic acid fillers are widely used for correction; however, complications such as Tyndall effect, edema, contour irregularities, and filler migration remain important concerns.
Objective: To evaluate the safety and effectiveness of a precision supraperiosteal microdroplet cannula technique for tear trough correction.
Methods: A case series of 20 patients aged 20–50 years presenting with tear trough deformity was conducted over a period of one year. Hyaluronic acid filler was injected using a 25G, 50‑mm blunt cannula via a single entry point over the zygomatic bone. Microdroplets of approximately 0.05 mL were deposited in the supraperiosteal plane along the nasojugal groove. Outcomes were assessed by immediate clinical improvement, standardized photographic documentation, and patient satisfaction measured using a 10‑point Likert scale. Final evaluation was performed at two weeks. Complications including Tyndall effect, prolonged swelling, and nodularity were recorded.
Results: All patients demonstrated visible improvement immediately after treatment. Maximum aesthetic correction was observed at the two‑week follow‑up. The mean satisfaction score was 8.25 ± 0.97 (range 6–10) with a 95% confidence interval of 7.83–8.67. No cases of Tyndall effect or prolonged edema occurred. Two patients developed small nodules which resolved after hyaluronidase injection.
Conclusion: The supraperiosteal precision microdroplet cannula technique appears to be a safe and effective method for tear trough rejuvenation with high patient satisfaction and minimal complications.
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