Dear Editor,
I read with interest the case report by Arıcı et al.1 and would like to share my thoughts about the lesion description and surgical approach.
The authors report en bloc excision of a lesion within the orbital fat at the infraorbital nerve and extraocular muscle level, following subperiosteal dissection in the inferior orbit. However, both magnetic resonance images show the lesions anterior to the inferior orbital rim, in a pre-periosteal position. There is no evidence of intraorbital extension or a mass suitable for en bloc excision. Also, the authors also reported palpation of a firm mass in the tear trough region, and the patient’s external photograph shows subcutaneous fullness. Therefore, the clinical and radiographic findings are inconsistent with the surgical description and do not support the migration of a filler material into the orbit.
The article title emphasizes that the patient denied a history of dermal filler injection. However, the patient later on admitted having undergone such a procedure. Highlighting the denial in the title may be misleading for readers.


