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combination treatment using Botox and filler is planned for this patient I like to palpate every patient and do markings for record documentation and patient education hyaluronic acid juv XE is used to correct the tear throw deformity initial injection is placed perpendicular to the skin Advanced underneath the orbicularis muscle at the Supra periostal plane and small slow injections are placed in a retrograde fashion index finger of the non-dominant hand is used to protect the eye Globe the most medial aspect of the tear throw is injected deep to the muscle stretching the skin of the nose most making sure of having visualization of the blood vessels gentle massage and pressure is applied to avoid broses the most lateral aspect of the infraorbital Holo is treated palpating the infraorbital rim and then the injections are placed again at the Supra periostal level up to the lateral cantis area gentle pressure will accommodate the product [M
