Comment to: Non-Surgical Novel Technique for Correction of Palpebromalar Groove (Tear Valley Deformity) and Extended Area: The Matador Stab

Dear Editor, We read with great interest the article titled ‘‘Non-Surgical Novel Technique for Correction of Palpebromalar Groove (Tear Valley Deformity) and Extended Area: The Matador Stab’’.[1] The Authors presented a very interesting approach for palpebromalar groove correction by filler injection, focusing specific anatomical landmarks involved in its genesis. We really appreciate the Authors efforts in investigation of anatomical relationship of palpebromalar groove, but we have some elements to discuss. Palpebromalar area is one of the most sensitive areas involved in the aging process of the face. Even in the presence of a minor deformity, the face appearance suffers from a negative influence, revealing sad, tired and unhappy aspect, making it to seem older than its real chronological age. Usually, patients suffer very much from this deformity. It could create discomfort and low self-confidence that potentially might interfere with the social life. Therefore, palpebromalar groove correction is one of the most popular patients’ requests in aesthetic medicine. Because of its high visibility, this anatomical area requires a very accurate approach; even minimal procedural errors could be extremely unpleasant. Nowadays, filler injection is one of the most popular methods to correct palpebromalar groove deformity. Many fillers are available for this purpose. Hyaluronic acid is one of the most employed in palpebromalar groove correction. However, due to its rheology, the risk of puffy appearance should be considered, especially in the presence of large amount of injected filler. Moreover, of the osmotic activity of the filler itself could render the correction unstable over time