Zhi-Feng Liao1 • Wei Yang2 • Xin Li3 •Shi-wei Wang3 •  Fang-Cen Liu4 • Sheng-Kang Luo1

1 Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City 510317, Guangdong Province, China

2 Department of Medical Cosmetology, Beijing Huaxia Medical Beauty Hospital, Beijing, China

3 Department of Medical, Imeik Technology Development Co., Ltd., Beijing, China

4 Guangzhou Yestar Medical Aesthetic Hospital, Guangzhou City, Guangdong Province, China

Received: 3 August 2023 / Accepted: 20 October 2023 / Published online: 14 November 2023 © The Author(s) 2023

Abstract

Background Infraorbital aging develops during the natural aging process. Various treatment options offer unique benefits, accompanied by diverse side effect profiles, and can be synergistically combined to optimize results. This study aimed to evaluate the efficacy of a comprehensive approach involving non-cross-linked hyaluronic acid injection and smooth absorbable PPDO (poly p-dioxanone) thread insertion for infraorbital rejuvenation.

Methods This retrospective case series study enrolled ten female patients with infraorbital aging from March 2022 to April 2023. Clinical outcomes, patient satisfaction, and adverse events were assessed at 1, 3, and 6 months

Results The median Global Aesthetic Improvement Scale scores evaluated by the operator and blinded evaluator were 1.70 ± 0.42 and 1.80 ± 0.35, respectively, at six months posttreatment. The median Allergan Infraorbital

Hollows Scale determined by the operator was 1.15 ± 0.34 at six months posttreatment, whereas the scores evaluated by the blinded evaluator were 1.15 ± 0.53. At six months after treatment, 50% of patients were satisfied, and an additional 40% reported strong satisfaction with the clinical improvement following treatment. No serious adverse events, such as infections, lumps, irregularities, Tyndall effect, hematoma, or skin necrosis, occurred during the treatment period.

Conclusions The combination of PPDO thread insertion and non-cross-linked hyaluronic acid injection yielded satisfactory and effective clinical outcomes with no occurrence of serious adverse events for infraorbital rejuvenation. We anticipate that this study will contribute to the advancement of novel treatment options for infraorbital  aging.

Level of Evidence IV

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Keywords Infraorbital rejuvenation   Hyaluronic acid injections  Thread-lifting  Infraorbital aging