Volumizing Thread (Sihler Volume Thread) Technique for Infraorbital Hollowness and Midcheek Groove

Background: Infraorbital hollowness significantly impacts facial aesthetics, contributing to a tired and aged appearance. Traditional treatments, such as fillers and botulinum toxin, can lead to unnatural results. Volumizing threads offer a minimally invasive alternative for enhancing infraorbital and midcheek areas. Objective: This study aims to evaluate the efficacy and safety of using absorbable polydioxanone (PDO) volumizing threads in treating infraorbital hollowness and midcheek grooves. Methods: Three patients with infraorbital hollowness underwent treatment with PDO threads (Volume Thread, Sihler Inc., Seoul, Korea). Threads were inserted using a cross-technique under the orbicularis oculi muscle to enhance volume and firmness. Outcomes were assessed based on patient satisfaction, clinical improvement, and adverse effects over a 6-month follow-up period. Results: All patients showed significant improvement in infraorbital volume and skin firmness, with a natural appearance maintained. Minor adverse effects, such as bruising, resolved within a week. No major complications were reported. Conclusion: PDO volumizing threads are a safe and effective option for infraorbital hollowness and midcheek groove correction, providing natural results with minimal complications.