Novel technique for infraorbital groove correction using multiple twisted polydioxanone thread.

[BACKGROUND] The infraorbital groove can be corrected by lower blepharoplasty, microfat grafting, and soft tissue filler injection. Recently, multiple twisted polydioxanone threads were developed for facial rejuvenation.

[OBJECTIVE] This study aimed to examine the efficacy and associated risks of the use of new synthetic threads for infraorbital groove correction.

[METHODS] From March 2018 to June 2019, 40 patients (mean age: 43.4 years; range: 25-56 years) underwent transcutaneous multiple twisted thread insertion to correct the infraorbital groove. Three threads were inserted along the infraorbital groove on each side. The outcomes were assessed based on a comparison between preprocedure and postprocedure findings. Barton's grading and Global Aesthetic Improvement Scale scores were assessed by two physicians. Patient satisfaction with the aesthetic outcome of the procedure was evaluated at the end of the procedure and after 3 months. Ultrasonographic evaluation was performed to confirm that the threads had been properly placed. The anatomical layer in which the threads were placed was evaluated in a cadaveric study.

[RESULTS] The mean Barton grade improved significantly (P < .001) without decline throughout the 12-week period. Improvement was found in all patients who were designated with a score >2 ("improved"). More than 77.5% of the patients were satisfied with the outcomes, and the rest of the patients reported some extent of correction with little satisfaction.

[CONCLUSIONS] The findings indicate the benefits of the multiple twisted polydioxanone thread insertion in the treatment of patients with infraorbital groove without septal protrusion. This evaluation raised no major safety concerns.