Nonsurgical Tear Trough Volumization: A Systematic Review of Patient Satisfaction.

BACKGROUND Nonsurgical rejuvenation of the tear-trough area via the use of injectable filler material has become a popular procedure in facial rejuvenation. This procedure offers immediate, albeit temporary, results with minimal recovery time. OBJECTIVES This systematic review aims to report on patient satisfaction and complication rates to further guide practitioners. METHODS PubMed, Cochrane, and Scopus libraries were queried for articles using the relevant terms. Articles with greater than 5 patients who reported on satisfaction and/or complications from the procedure were included for review. Besides these variables, we noted other aspects of injection such as filler material, technique, needle or cannula delivery, among others. Studies which did not otherwise fulfill inclusion criteria for statistical analysis but reported on intravascular injection related complications were cited. RESULTS Initial query resulted in 1,655 studies which were assessed for duplicates and inclusion/exclusion criteria. After screening, 28 articles were included for analysis. 1,956 patients were captured who had been injected with one of 4 materials: hyaluronic acid (1,535), CaHa (376), autologous fibroblast/keratin gel (35), and collagen-based filler (10). Short- and long-term satisfaction rates were 84.4% and 76.7%, respectively. Minor complications were common (44%). Secondarily, we found the use of cannula for filler injection of this region to be associated with a lower rate of ecchymosis (7% vs 17%, p<0.05). CONCLUSION Filler injection volumization of the tear-trough deformity is an effective technique for facial rejuvenation associated with high patient satisfaction. Multiple filler materials offer acceptable satisfaction and complication profiles.