The Safety of Injections in the Infraorbital Region

Aesthetic Plast Surg. 2024 Mar 25. doi: 10.1007/s00266-024-03976-5. Online ahead of print.

Abstract

Background: Infraorbital filler injection is a commonly used minimally invasive cosmetic procedure on the face, which can cause vascular complications.

Objective: In this study, we aimed to explore the anatomical structure of the infraorbital vasculature and to establish an accurate protocol for infraorbital filler injection.

Methods: The vascular structure of the infraorbital region was evaluated in 84 hemifacial specimens using computed tomography. Four segments (P1-P4) and five sections (C1-C5) were considered. We recorded the number of identified arteries in each slice and at each location and the number of deep arteries. Furthermore, we also measured the infraorbital artery (IOA) distribution.

Results: At P1-P4, the lowest number of arteries was detected in segment P4, with a 317/1727 (18.4%) and 65/338 (2.3%) probability of total and deep arterial identification, respectively. The probabilities of encountering an identified artery at the five designated locations (C1-C5) were 277/1727 (16%), 318/1727 (18.4%), 410/1727 (23.7%), 397/1727 (23%), and 325/1727 (18.8%), respectively. The probability of an IOA being identified at C2 was 68/84 (81%).

Conclusion: We described an effective filler injection technique in the infraorbital region to minimize the associated risks.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Infraorbital artery; Infraorbital depression; Periorbital region; Tear trough injection.