Reply to: Comment to: Hyaluronic Acid Injection Strategy of Infraorbital and Midfacial Rejuvenation for Women in Southeast China.

Tear trough correction poses unique challenges due to complex anatomy and ethnic variations. While immediate outcomes do not represent long-term efficacy, they are crucial for patient satisfaction in minimally invasive aesthetic procedures. In our cohort, no significant complications were observed, and patient satisfaction remained at 6-month follow-up. To avoid local bulging and unnatural appearance, the filler volume should be minimal due to the thin infraorbital skin and tissues. To minimize lymphatic obstruction and infraorbital edema, we delete CK2 injection point and avoid increasing zygomatic prominence appearance in Southeast Chinese women. Based on numerous eyelid surgeries and related anatomical research, we assumed orbital fat herniation, rather than ligament tethering, to be the primary cause of tear trough deformity in this population. Excessive dissection should be avoided to reduce bruising, swelling, and filler migration. We currently employ various MD Codes™ and other sub-orbicularis oculi injection techniques for individualized tear trough correction. Further long-term and cross-ethnic studies are needed to optimize outcomes. Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .