ISSN 2449-8947 MicroMedicine Research Article MicroMedicine 2020; 8(2): 74-80 DOI: http://dx.doi.org/10.5281/zenodo.4272439 Superficial technique for tear trough filling with cohesive polydensified matrix hyaluronic acid Marisa Gonzaga da Cunha 1 , Ana Lúcia Gonzaga da Cunha 1 , Meire Gonzaga 1 , Fernando Luiz A. Fonseca 2, 3 , Glaucia Luciano da Veiga 2 *, Carlos D’ Apparecida Machado Filho 1 1 Dermatology Discipline, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil 2 Clinical Analysis Department, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil 3 Pharmaceutical Sciences Department, Universidade Federal de São Paulo, Diadema, São Paulo, Brazil * Corresponding author: Phone: +5511 4993-5488; E-mail: grlveiga@gmail.com Received: 17 July 2020; Revised submission: 18 September 2020; Accepted: 17 October 2020 http://www.journals.tmkarpinski.com/index.php/mmed Copyright: © The Author(s) 2020. Licensee Joanna Bródka, Poland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/) ABSTRACT: Introduction: Deep tear troughs create unaesthetic hollows that often worsen the color alteration and aspect of dark undereye circles, thus giving an aged and tired appearance to the eyes, even in younger individuals. The use of dermal fillers for the restoration of volume loss in the area, with a wide variety of products and techniques, has been the most suitable treatment. Aim: Description and evaluation of the superficial intradermal injection technique for tear trough filling using cohesive polydensified matrix hyaluronic acid. Materials and Methods: 120 patients from Faculdade de Medicina do ABC’s Cosmetic Dermatology Sector and a private practice treated between the years 2011 and 2016. Results: All the patients rated the treatment result as good or very good. No important or long-lasting adverse effects were reported; the Tyndall effect was not observed either. Conclusion: The superficial technique is an easy and safe method to treat the tear trough deformity, with high rates of good aesthetic results. Keywords: Cosmetic; Treatment; Hyaluronic acid; Intradermal injection; Hirmand’s scale. 1. INTRODUCTION The search for the prevention or correction of aging signs in the facial area has stimulated the development of new surgical techniques and minimally invasive non-surgical treatments [1, 2]. Special attention has been given to the periocular region, in which multifactorial alterations - skin texture, coloration and firmness, bone resorption and displacement of soft parts - result in the emergence of depigmentation, grooves and/or fat pads. According to individual clinical findings, just one therapeutic option may not be sufficient [1, 2]. One of the major complaints regarding the lower eyelid region is the tear trough deformity. It creates unaesthetic hollows that often worsen the color alteration and aspect of dark undereye circles, thus giving an aged and tired appearance to the eyes, even in younger individuals [3, 4]. It is the cutaneous groove that runs obliquely and inferolaterally, from the inner canthus of the eye to approximately the mid-pupillary line, and can continue laterally with the palpebromalar sulcus [3-5]. It can be the result of genetic and anatomical