Sunken eye sockets are one of the common clinical manifestations of facial aging. With age, periorbital fat atrophy, bone absorption and soft tissue relaxation can lead to collapse of the eye socket area, worsening of shadows, and increased visual fatigue. In order to improve the above problems, eye socket filling technology has gradually been widely used in the field of medical cosmetology. This article will systematically discuss the types of materials commonly used for eye socket filling, the indications, advantages and disadvantages of various materials, aiming to provide a scientific basis and reference for clinical practice.
Causes and anatomical basis of sunken eye sockets
Sunken eye sockets are mainly caused by the following factors:
Fat atrophy and displacement : With age, the orbicularis oculi muscle and orbital fat atrophy and move downward, causing depression in the inner canthus and lower eyelid area.
Bone absorption : The bones in the supraorbital margin and medial canthal groove area are gradually absorbed with age, and the orbital space expands, creating a sunken feeling.
Ligament relaxation : The supporting structures of the eye, such as the orbital septum and ligament system, degenerate and relax, which weakens the supporting force of the orbital fat and further aggravates the sunken eye socket.
From an anatomical perspective, the key areas for orbital filling include the supraorbital rim, medial canthal sulcus, suborbicularis oculi muscle and orbital fat area. Choosing the appropriate filling material and injection level is crucial to the treatment effect.
Classification and characteristics of commonly used eye socket filling materials
Eye socket filling materials can be divided into three categories: autologous tissue, absorbable synthetic, and semi-permanent synthetic . Each type of material differs in biocompatibility, durability, and injection risks.
1. Autologous fat
Autologous fat is one of the most commonly used filling materials in clinical practice.
advantage :
②. Wide sources and good biocompatibility;
③. Small graft rejection reaction;
④. Can be combined with comprehensive facial rejuvenation surgery.
shortcoming :
The absorption rate is high, and multiple injections may be required after surgery;
The operation depends on the doctor's skills, and fat extraction, purification and injection require careful control;
Improper injection in delicate periorbital areas may result in the formation of nodules or fat lumps.
Currently, nano fat or micro fat is mostly used in the eye socket area. It has better fluidity and integration, and is suitable for shallow injection and transition area shaping.
2. Hyaluronic acid (HA)
Hyaluronic acid is a type of absorbable filling material that is widely used in clinical practice.
advantage :
②. The injection operation is simple and reversible;
③. Flexible layer control, can be used for shallow and deep tissues;
④. Foreign body reaction and inflammation are rare.
shortcoming :
The absorption rate is fast, and the duration is limited;
Repeated injections may produce tissue sclerosis or edema;
When injecting into the supraorbital cavity and medial canthal groove, attention should be paid to vascular anatomy to avoid vascular embolism.
In the eye socket area, it is recommended to use low-cross-linked, low-concentration hyaluronic acid products to reduce the risk of compressing tissue or causing protrusions. They are often used for mild depressions or postoperative modification and supplementation.
3. Poly-L-lactic acid (PLLA) and hydroxyapatite (CaHA)
These synthetic fillers have the property of stimulating collagen production.
advantage :
②, It can induce autologous collagen reconstruction by stimulating fibroblast proliferation;
③. The duration of maintenance is relatively long, generally 12-18 months;
④. Suitable for middle-aged and elderly patients with soft tissue atrophy in the orbital area.
shortcoming :
The effect is slow and requires multiple injections;
It is not suitable for shallow injection, as improper injection level control may lead to nodules.
There is a risk of inflammation or fibrosis.
Among them, poly-L-lactic acid needs to be prepared strictly according to the dilution ratio, and it is recommended to be injected in the periosteum or deep fascia layer . Hydroxyapatite is mostly used for deep support in the mid-face, and should be used with caution for filling the eye socket.
Material selection basis and injection strategy
When choosing an orbital filling material, the patient's individual anatomy, degree of depression, desired duration, and previous injection history should be considered .
For patients with mild to moderate depression , hyaluronic acid or a small amount of autologous fat injection can be given priority, focusing on transition and naturalness.
For patients with moderate to severe depression accompanied by soft tissue atrophy , autologous fat or poly-L-lactic acid can be used to enhance structural support.
For those who need long-term maintenance , the use of poly-L-lactic acid or CaHA can be evaluated, supplemented by regular revision injections.
The injection level must be precisely controlled between the periosteum and the anterior orbital septum to avoid entering the superficial layer of the orbicularis oculi muscle or the orbital septum, thereby reducing the foreign body sensation or risk of embolism.
Suggestions for prevention and treatment of complications
Although eye socket filling is a relatively safe minimally invasive procedure, it is still important to pay attention to possible complications:
Vascular embolism : Especially in the medial canthal sulcus area, where the ophthalmic artery has abundant branches, the injection level and pressure should be strictly controlled.
Fat or filler nodules : Concentrated accumulation can be avoided through low-dose, multi-point injections.
Edema and congestion : It is recommended to apply cold compress for 48 hours after injection and avoid strenuous activities and pressure.
Asymmetry or displacement : The design should be precise before injection and adjusted and supplemented as needed after surgery.
If serious complications occur, such as visual impairment or severe pain, the injection should be stopped immediately, and hyaluronidase (if hyaluronic acid has been used) or emergency treatment should be given, and the patient should be transferred to an ophthalmologist for treatment if necessary.
Beauty Encyclopedia Tips:
Socket filling is one of the important means of facial rejuvenation. The matching of material selection and injection technology determines the naturalness and stability of the final effect. Clinical operations should be performed by qualified professional doctors, following the principles of individualized evaluation and safe injection. At the same time, sufficient communication and expectation management should be carried out before the operation, and regular follow-up should be carried out after the operation to ensure the maximization of filling effect and patient satisfaction.