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<hr />Leila Annaeva , PhD, dermatologist, cosmetologist, founder of Masterliness clinic, member of EADV, American Academy of Anti Age.<hr /> The tear trough and the presence of dark circles under the eyes can be markers of involutional changes, and can also be present in young people due to the peculiarities of the anatomical structure, which gives the effect of a “tired face”. When the first changes occur in the periorbital area, there is no point in immediately resorting to blepharoplasty, since the situation can be corrected with the help of dermal fillers. As an example, consider the correction of the nasolacrimal groove with <a href="http://betelgeizua.com/">ENA Betelgeiz</a> Soft. For contour injection plastic surgery, the periorbital area is the most difficult area of correction due to the peculiarities of the anatomical structure, the severity of the tear trough, the presence of dangerous zones (medial angle of the eye, projection of the exit of the infraorbital neurovascular bundle), features of the choice of drug and the ambiguity of the prognosis of the final result. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3942.jpg" /> 1. Medial corner of the eye. 2. Projection of the exit of the infraorbital neurovascular bundle. Indications for correction of the nasolacrimal trough: - the appearance of dark circles under the eyes; - the appearance of a “tired look”; - appearance of facial wrinkles in the periorbital zone; Contraindications: - tendency to swelling in the periorbital area; - presence of pronounced hernias of the lower eyelids; - recovery period after blepharoplasty (4-6 months); - inflammatory processes in the periorbital area (keratitis, uveitis, neuritis, diabetic retinopathy, endocrine ophthalmopathy). Procedure protocol:<ol><li> We conduct an examination, collect anamnesis, and take photos of the area where the drug is supposed to be administered.</li><li> We fill out informed consent for the procedure.</li><li> We treat the correction area with a disinfectant solution.</li><li> We apply application anesthesia in the area of the lower eyelid for 20-30 minutes. After removing any remaining anesthetic, treat the skin with a disinfectant.</li><li> Marking. We mark the area of the tear trough and determine the degree of displacement of soft tissues relative to the bony edge of the orbit, and highlight dangerous zones.</li></ol> <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3945.JPG" /> 6. Inject the drug <a href="http://betelgeizua.com/">Ena Betelgeiz</a> Soft with a 30G 1/2 needle deeply by vertical injection at an angle of 35 degrees to the bony edge of the orbit into the center of the lacrimal groove with microboluses from 0.02 to 0.05 ml. The total consumption of the drug is 0.4-0.7 ml. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3947.JPG" /> <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3950.JPG" /> The filler must be injected at the supraperiosteal level along or below the orbital rim. In this case, the doctor controls the orbital edge with his free hand to avoid introducing the drug over this structure. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3952.JPG" /> Most of the drug is injected under the orbicularis oculi muscle, but in the medial part of the muscle, which is attached to the bone, a direct injection into the muscle itself is required. 7. We carry out a light massage of the area where the drug was introduced in order to distribute the filler evenly. 8. Treat the skin with a disinfectant solution and, if necessary, apply Traumeel S cream. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3975.JPG" /> The advantage of the procedure using ENA Betelgeiz Soft is that there is an absolutely natural effect, the duration of which is more than 12 months, with virtually no recovery period, which makes the procedure very comfortable and safe. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_3917.JPG" style="width: 960px; height: 650px;" /> Photo 1. Before the procedure <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/files/IMG_4020.JPG" style="width: 960px; height: 650px;" /> Photo 2. After the procedure <a href="http://betelgeizua.com/">ENA Betelgeiz</a> Soft is a dermal filler based on hyaluronic acid containing 24 mg/ml with lidocaine. The uniqueness of ENA Betelgeiz fillers lies in the high concentration of cross-linked hyaluronic acid; an important aspect is also the pronounced elasticity and low hydroscopicity of the fillers, which facilitates smooth insertion and ensures a guaranteed result without the risk of swelling after the procedure. The original drug can only be purchased from the official representative of the company LLC &quot;BETELHEITZ UA&quot;.

Correction of the nasolacrimal groove with dermal filler ENA Betelgeiz