PREMIUM ARTICLE PREVIEW
While injectable compounds developed for filling skin wrinkles and superficial skin indentations (such as hyaluronic acid, calcium hyroxylapatite, or poly-L-lactic acid) may be used in augmenting the tear trough or other areas of depression along the upper cheek, they are temporary in effect and not inexpensive.
Dermal fillers are intended for injection into the dermis (second layer of the skin) or subdermally at the dermal-subcutanous fat junction (diagram). Unlike other facial skin, the eyelid skin has an extremely thin dermis and contains almost no subcutaneous fat (not to be confused with the much deeper orbital fat).
If a dermal filler is injected superficially when a volume deficit is much deeper (such as in a hollowed eyelid missing adequate orbital fat), the effect may resemble built-up putty hiding a bad dent or crack . . .