In their cadaveric study of 36 hemifaces, the authors describe a ligamentous structure that arises from medial orbital rim periosteum and inserts into dermis. The authors suggest that this is an osteocutaneous ligament that defines the anatomical area referred to as the tear trough or medial nasojugal crease. The conclusion of the article is that the tear trough ligament is the primary etiologic factor in the development of the tear trough deformity; effective treatment requires submuscular preperiosteal release to effect a marked correction.
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