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Fillers
Fillers
Periorbital skin is thin and delicate; hence, filler selection and injection requires the utmost attention. HA products such as Juvedermยฎ Volift, Juvederm Ultra Plus, Restylane Lyft, Restylane Defyne, or Beloteroยฎ Intense can be used for deeper filler placements whereas Juvederm Volbella, Restylane Refyne, Restylane Fynesse, and Belotero Balance can be used for more superficial placement.
Drooping of the lateral brow can be corrected with deep filler placement in the subgaleal plane. This can be achieved through fanning with a blunt cannula or microdroplets using the serial puncture technique. Indirect elevation of the lateral brow can also be achieved by deeper placement of fillers with lifting capacities such as Juvederm Voluma or Restylane Lyft in the zygomaticotemporal suture line on the zygomatic arch. More superficial filler placement to correct deep static brow rhytides can be attained by using anterograde or retrograde linear threading injections. Caution is warranted in this zone because of the tenuous blood supply. Global brow lift can also be achieved by deep placement of fillers on the orbital rim using a blunt cannula entering from a point over the lateral portion of the brow. Deep injections are not advised for the medial portion of the brow so as to avoid vessels and nerves that emanate from the supraorbital and supratrochlear notches.