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. CONCLUSION: 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.

Combination therapies in oculofacial rejuvenation.

The oculo-facial surgeon's quest for non-invasive procedures is a response to increasing patient demands for enhanced results without any downtime. Technology has obliged us with multiple injectable and light therapeutic modalities that tighten skin, relax and fill in wrinkles, and improve skin dyspigmentation and texture. When these techniques are combined, the results are superior to the use of individual therapies alone. The foundation for combination therapies are: botulinum toxin, filling agents, chemical peels, intense pulsed light, non-ablative and ablative lasers.

An ophthalmologist's guide to chemical peels.

This article discusses the use of different chemical peels-very superficial, superficial, and medium depth. Once ophthalmologists understand the value and indications of this therapy, learn the techniques of application, and feel comfortable and confident with these methods, they should be able to treat the entire face.

Patient home care regimens.

Combinations of in-office and home care treatment modalities are effective in the improvement and maintenance of photodamaged skin. A regimen of daily internal supplementation and application of topical products will prolong and enhance the effects of noninvasive and surgical procedures.

Nonanimal stabilized hyaluronic acid for lip augmentation and facial rhytid ablation.

OBJECTIVE: To evaluate the effectiveness of nonanimal stabilized hyaluronic acid as an injectable filling agent. DESIGN: Nonrandomized, retrospective, interventional case series. RESULTS: A total of 1446 consecutive patients (1029 women and 417 men) underwent intradermal injection of commercially available nonanimal stabilized hyaluronic acid (2242 treatments) for the enhancement of lip volume and contour and the reduction of visible facial rhytids. Almost 61% of all patients remained satisfied with their results after 9 months. The effect was longest in the glabellar and nasolabial fold areas. Minimal transient sequelae were noted. CONCLUSIONS: Nonanimal stabilized hyaluronic acid is an effective and safe facial soft tissue expander. Its duration varies with each facial area treated.