The tear trough deformity and the palpebromalar groove are characteristic appearances in midface
aging. The aim of this study is to suggest the direction of aging process in midface by sampling survey
in the Koreans. Sampling survey was conducted to 480 subjects who had preoperative pictures of the
midface in Koreans. The excluding criteria of the subjects were with prior oculoplastic surgery, facial
bone fracture, facial palsy, previous rejuvenation procedure, Grave’s oculopathy and some medical
history affecting eyelid position. Prevalence of tear trough deformity and palpebromalar groove in
each subject, and age-related change in prevalence were analyzed. Prevalence of the tear trough
deformity and the palpebromalar groove was 57.92% and 44.58%, respectively. Prevalence of tear
trough deformity was higher than that of palpebromalar groove in both males and females (Chi-
Square test, p <0.05). The tear trough deformity and the palpebromalar groove showed a strong
positive correlation with age. All the subjects with the palpebromalar grooves had the tear trough
deformities. From the results of survey, it suggested that the aging process of midface of the Korean,
from medial to lateral direction, differed from that in westerns.