Objective:To investigate the clinical efficacy and safety of collagen injection in improving periorbital aging.Methods:The data of patients receiving collagen injections treated for periorbital aging at Hangzhou Xueran Medical Beauty Clinic from December 2023 to July 2024 were analyzed retrospectively. Pre-injection facial photographs were taken to assess periorbital aging severity. A domestic collagen filler (35 mg/ml premixed with 0.3% lidocaine) was injected. First, 30 G sharp needle was used to inject filler into the periorbital periosteal layer through 6 points on each side. After that, 27 G blunt needle was used to give falloped flat injection in the subcutaneous and under the orbicularis oculi muscle, respectively, from 2 points on each side. Total doses (1-6 ml) were determined by aging severity. Based on prior pain perception experiences, injection sites were categorized into three zones. Psychological interventions were implemented during left facial injections, while right facial injections served as non-intervention controls. Post-procedure care included erythromycin ointment application and ice compression. Patient images were obtained immediately post-treatment, at 1 month, and 3 months after treatment. Periorbital aging rating scale (PARS) was assessed by third-party. The higher the scale rating, the more severe the periorbital aging. After treatment, a reduction of 1 grade from the pre-treatment rating was regarded as effective improvement, and a reduction of ≥2 grades was regarded as significant improvement. Global aesthetic improvement scale (GAIS) was assessed by the patients. The full score was 5, the higher the score, the greater the improvement. The patient satisfaction was evaluated by self-made scale. The effectiveness of psychological intervention was evaluated by patients immediately after treatment. The complications were followed up and recorded. SPSS 26.0 software was used for statistical analysis, and the measurement data were expressed as Mean±SD. Paired sample t-test was used to compare the same patient before and after treatment. Counting data was expressed as cases (%). Results:A total of 45 patients were included, including 10 males and 35 females, aged (35.6±8.0) years (25-55 years). All patients were followed up. PARS evaluation showed that, PARS rating at immediately after injection, 1 month and 3 months after injection[(1.3±0.7), (1.1±0.6), (1.2±0.7) grade] was significantly decreased ( t=23.45, 25.38, 26.36, all P<0.001), compared with that before treatment[(2.2±0.6) grade]. All patients achieved significant or effective improvement immediately and 1 month after treatment. Only 1 patient’s rating recovered to the pre-treatment level 3 months after treatment. After treatment, GAIS scores remained stable as 4.8±0.4 (immediate) vs. 4.9±0.3 (1-month) vs. 4.6±0.5 (3-month), showing no significant differecnce ( t=-1.98, 1.52; P=0.058, 0.135). 44 cases (97.8%) reported satisfied results and maintained improvement with high satisfaction, while 1 case (2.2%) noted mostly loss at 3 months. All patients (100%) perceived enhanced comfort during left-side psychological interventions. Adverse events included 1 case (2.2%) of transient ecchymosis resolving within 5 days. No allergies, nodules, or vascular complications occurred. Natural dynamic expressions were maintained in all patients at 3 months. Conclusion:Periocular collagen injection can effectively improve the signs of aging around the eyes and exhibit good long-term effect. The implementation of psychological interventions during the injection treatment can effectively alleviate fear and anxiety, significantly enhance treatment comfort.

Objective:To investigate the clinical efficacy and safety of collagen injection in improving periorbital aging.Methods:The data of patients receiving collagen injections treated for periorbital aging at Hangzhou Xueran Medical Beauty Clinic from December 2023 to July 2024 were analyzed retrospectively. Pre-injection facial photographs were taken to assess periorbital aging severity. A domestic collagen filler (35 mg/ml premixed with 0.3% lidocaine) was injected. First, 30 G sharp needle was used to inject filler into the periorbital periosteal layer through 6 points on each side. After that, 27 G blunt needle was used to give falloped flat injection in the subcutaneous and under the orbicularis oculi muscle, respectively, from 2 points on each side. Total doses (1-6 ml) were determined by aging severity. Based on prior pain perception experiences, injection sites were categorized into three zones. Psychological interventions were implemented during left facial injections, while right facial injections served as non-intervention controls. Post-procedure care included erythromycin ointment application and ice compression. Patient images were obtained immediately post-treatment, at 1 month, and 3 months after treatment. Periorbital aging rating scale (PARS) was assessed by third-party. The higher the scale rating, the more severe the periorbital aging. After treatment, a reduction of 1 grade from the pre-treatment rating was regarded as effective improvement, and a reduction of ≥2 grades was regarded as significant improvement. Global aesthetic improvement scale (GAIS) was assessed by the patients. The full score was 5, the higher the score, the greater the improvement. The patient satisfaction was evaluated by self-made scale. The effectiveness of psychological intervention was evaluated by patients immediately after treatment. The complications were followed up and recorded. SPSS 26.0 software was used for statistical analysis, and the measurement data were expressed as Mean±SD. Paired sample t-test was used to compare the same patient before and after treatment. Counting data was expressed as cases (%). Results:A total of 45 patients were included, including 10 males and 35 females, aged (35.6±8.0) years (25-55 years). All patients were followed up. PARS evaluation showed that, PARS rating at immediately after injection, 1 month and 3 months after injection[(1.3±0.7), (1.1±0.6), (1.2±0.7) grade] was significantly decreased ( t=23.45, 25.38, 26.36, all P<0.001), compared with that before treatment[(2.2±0.6) grade]. All patients achieved significant or effective improvement immediately and 1 month after treatment. Only 1 patient’s rating recovered to the pre-treatment level 3 months after treatment. After treatment, GAIS scores remained stable as 4.8±0.4 (immediate) vs. 4.9±0.3 (1-month) vs. 4.6±0.5 (3-month), showing no significant differecnce ( t=-1.98, 1.52; P=0.058, 0.135). 44 cases (97.8%) reported satisfied results and maintained improvement with high satisfaction, while 1 case (2.2%) noted mostly loss at 3 months. All patients (100%) perceived enhanced comfort during left-side psychological interventions. Adverse events included 1 case (2.2%) of transient ecchymosis resolving within 5 days. No allergies, nodules, or vascular complications occurred. Natural dynamic expressions were maintained in all patients at 3 months. Conclusion:Periocular collagen injection can effectively improve the signs of aging around the eyes and exhibit good long-term effect. The implementation of psychological interventions during the injection treatment can effectively alleviate fear and anxiety, significantly enhance treatment comfort.

Objective:To explore the efficacy and safety of restylane volyme cross-linked sodium hyaluronate gel injection via dual-plane technique for cheek depression and mild to moderate skin laxity in the mid-lower face.Methods:The data of patients with cheek concavity accompanied by mild to moderate skin laxity in the mid-lower face treated at Jinan MeiAo Plastic Surgery Hospital from February 2023 to January 2024 were retrospectively collected. The treatment was injection of cross-linked sodium hyaluronate gel via double-plane technique, with needle insertion points located 1-2 cm anterior to the tragus. After insertion, a 23 G blunt needle was used to fanwise inject the subcutaneous fat (superficial layer) and the subcutaneous (deep layer) fat compartments in the concave area of the cheek, and a suitable amount of subcutaneous injection was administered below the zygomatic arch to soften the prominent zygomatic arch and achieve natural smoothness of the filling area. The total volume injected per side ranged from 1.5 to 3.5 ml. The patient’s skin condition was closely observed during the injection process, followed by gentle compression after injection. Patient images were collected preoperatively, immediately postoperatively, and at 6 months postoperatively. Blind evaluator used the facial laxity rating scale (FLRS) and medicis midface volume scale (MMVS) to evaluate the improvement in facial laxity and fullness. A higher rating/score of the scale indicates greater laxity or worse fullness of the face, and a decrease of 1 grade/point postoperatively compared to preoperative status was considered effective, while a decrease of ≥2 grades/points was considered significantly effective. Patients used the global aesthetic improvement scale (GAIS) to self-assess the improvement in facial appearance before and after treatment, with a maximum score of 5 points indicating the most noticeable improvement. Patient satisfaction and effect durability were investigated using a self-made satisfaction scale. The occurrence of patient complications was recorded. Data were analyzed using SPSS 26.0 statistical software, with measurement data expressed as Mean±SD, and paired t-tests used for comparison of GAIS scores immediately postoperatively and at 6 months postoperatively within the same patient. Categorical data were presented as cases (%). Results:A total of 80 female patients aged 30 to 50 years were included, all of whom were followed up for over 6 months. The FLRS grades showed that compared with preoperative status, all patients immediately postoperatively were rated as effective (69 cases, 86.3%) or significantly effective (11 cases, 13.8%). Compared with immediately postoperatively, 74 cases (92.5%) had no change in rating at 6 months postoperatively, while 6 cases (7.5%) experienced a 1-grade increase, indicating a slight reduction in treatment efficacy. The MMVS scores of the right and left facial sides of patients showed that compared with preoperative status, all patients immediately postoperatively achieved effective (right side: 55 cases, 68.8%; left side: 69 cases, 86.2%) or significantly effective (right side: 25 cases, 31.2%; left side: 11 cases, 13.8%) improvement in facial fullness. Compared with immediately postoperatively, at 6 months postoperatively, right side of 70 cases (87.5%) and left side of 77 cases (96.2%) had no change in grading, the other 12 patients (13 sides) increased by 1 point, indicating that the treatment effect was slightly weakened. All patients believed that their facial appearance improved after treatment, with GAIS scores of 4.5±0.5 immediately after treatment, while of 4.4±0.5 at 6 months postoperatively, the difference was not statistically significant ( t=1.08, P=0.280). The satisfaction rate (very satisfied+ satisfied) immediately postoperatively was 97.5% (78/80). Seventy-two (90.0%) cases expressed willingness to undergo secondary treatment. At 6 months post-treatment, the satisfaction rate (very satisfied+ satisfied) with treatment improvement and maintenance was 98.8% (79/80). Sixty-eight (85.0%) cases believed the treatment improvement effect could be maintained for about 6 months. One patient experienced mild redness and slight swelling in the injection area immediately postoperatively, which subsided after icing. No other obvious adverse reaction occurred. Conclusion:The use of double-plane technique injection of cross-linked sodium hyaluronate gel can safely and effectively improve cheek concavity, alleviate mild to moderate skin laxity in the mid-lower face, and maintain treatment efficacy for approximately 6 months.

Objective:To explore the efficacy and safety of restylane volyme cross-linked sodium hyaluronate gel injection via dual-plane technique for cheek depression and mild to moderate skin laxity in the mid-lower face.Methods:The data of patients with cheek concavity accompanied by mild to moderate skin laxity in the mid-lower face treated at Jinan MeiAo Plastic Surgery Hospital from February 2023 to January 2024 were retrospectively collected. The treatment was injection of cross-linked sodium hyaluronate gel via double-plane technique, with needle insertion points located 1-2 cm anterior to the tragus. After insertion, a 23 G blunt needle was used to fanwise inject the subcutaneous fat (superficial layer) and the subcutaneous (deep layer) fat compartments in the concave area of the cheek, and a suitable amount of subcutaneous injection was administered below the zygomatic arch to soften the prominent zygomatic arch and achieve natural smoothness of the filling area. The total volume injected per side ranged from 1.5 to 3.5 ml. The patient’s skin condition was closely observed during the injection process, followed by gentle compression after injection. Patient images were collected preoperatively, immediately postoperatively, and at 6 months postoperatively. Blind evaluator used the facial laxity rating scale (FLRS) and medicis midface volume scale (MMVS) to evaluate the improvement in facial laxity and fullness. A higher rating/score of the scale indicates greater laxity or worse fullness of the face, and a decrease of 1 grade/point postoperatively compared to preoperative status was considered effective, while a decrease of ≥2 grades/points was considered significantly effective. Patients used the global aesthetic improvement scale (GAIS) to self-assess the improvement in facial appearance before and after treatment, with a maximum score of 5 points indicating the most noticeable improvement. Patient satisfaction and effect durability were investigated using a self-made satisfaction scale. The occurrence of patient complications was recorded. Data were analyzed using SPSS 26.0 statistical software, with measurement data expressed as Mean±SD, and paired t-tests used for comparison of GAIS scores immediately postoperatively and at 6 months postoperatively within the same patient. Categorical data were presented as cases (%). Results:A total of 80 female patients aged 30 to 50 years were included, all of whom were followed up for over 6 months. The FLRS grades showed that compared with preoperative status, all patients immediately postoperatively were rated as effective (69 cases, 86.3%) or significantly effective (11 cases, 13.8%). Compared with immediately postoperatively, 74 cases (92.5%) had no change in rating at 6 months postoperatively, while 6 cases (7.5%) experienced a 1-grade increase, indicating a slight reduction in treatment efficacy. The MMVS scores of the right and left facial sides of patients showed that compared with preoperative status, all patients immediately postoperatively achieved effective (right side: 55 cases, 68.8%; left side: 69 cases, 86.2%) or significantly effective (right side: 25 cases, 31.2%; left side: 11 cases, 13.8%) improvement in facial fullness. Compared with immediately postoperatively, at 6 months postoperatively, right side of 70 cases (87.5%) and left side of 77 cases (96.2%) had no change in grading, the other 12 patients (13 sides) increased by 1 point, indicating that the treatment effect was slightly weakened. All patients believed that their facial appearance improved after treatment, with GAIS scores of 4.5±0.5 immediately after treatment, while of 4.4±0.5 at 6 months postoperatively, the difference was not statistically significant ( t=1.08, P=0.280). The satisfaction rate (very satisfied+ satisfied) immediately postoperatively was 97.5% (78/80). Seventy-two (90.0%) cases expressed willingness to undergo secondary treatment. At 6 months post-treatment, the satisfaction rate (very satisfied+ satisfied) with treatment improvement and maintenance was 98.8% (79/80). Sixty-eight (85.0%) cases believed the treatment improvement effect could be maintained for about 6 months. One patient experienced mild redness and slight swelling in the injection area immediately postoperatively, which subsided after icing. No other obvious adverse reaction occurred. Conclusion:The use of double-plane technique injection of cross-linked sodium hyaluronate gel can safely and effectively improve cheek concavity, alleviate mild to moderate skin laxity in the mid-lower face, and maintain treatment efficacy for approximately 6 months.