The Feasibility Determination of Risky Severe Complications of Arterial Vasculature Regarding to the Filler Injection Sites at the Tear Trough

Background: The tear trough is a significant sign of the eye and periorbital aging and has been usually corrected with filler injection. However, the arterial supply surrounding the tear trough could be inadvertently injured during injection; therefore, this study aimed to evaluate the nearest arterial locations related to the tear trough and investigate the possibility of severe complications following filler injection. Methods: Thirty hemi-faces of 15 Thai embalmed cadavers were utilized in this study. Results: The artery located closest to both the inferior margin (TT1) and mid pupil level (TT2) of tear trough was found to be the palpebral branch of the infraorbital artery. Furthermore, at 0.5 mm along the tear trough from the medial canthus (TT3), the angular artery was identified which was a found to be a branch of ophthalmic artery. The artery at TT1 and TT2 was located both of the zygomaticus major muscle and orbicularis oculi muscle. The distances from TT1 to the artery were measured as follows; laterally. 2.79 ± 1.08 mm along the X-axis and inferiorly 2.88 ± 1.57 mm along the Y-axis. For the TT2, the artery was located infero-medially from the landmark of 4.65 ± 1.83 mm along the X-axis and 7.13 ± 3.99 mm along the Y-axis. However, the distance along the X-axis at TT3 was located medially as 4.00 ± 2.37 mm. Conclusion: The high risky injured artery at the tear trough should be considered due to the numerous arterial supplies which accompany the facial artery and traverse at varying tissues depths to this area. Financial Disclosure Statement: All authors have nothing to disclose. No funding was received for this article. Acknowledgments: The 100th Anniversary Chulalongkorn University Fund for Doctoral Scholarship from the Graduate School, Chulalongkorn University Corresponding author: Tanvaa Tansatit, MD, MSc, Department of Anatomy, Faculty of Medicine, and The Chula Soft Cadaver Surgical Training Center, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok 10330 Thailand. E-Mail: orange_anatomist@hotmail.com ©2018American Society of Plastic Surgeons