The perialar region is notoriously known for being a high-risk zone with regards to soft tissue augmentation. The deep pyriform space is a relatively overlooked treatment area and was only well-described in detail a few years ago.1
In 2008, Rohrich et al. termed a space medial and deep to the deep medial fat compartment as ‘Ristow’s space’.2 In 2016, Surek et al. described the anatomical boundaries of this space in more detail and proposed a name change to the deep pyriform space for anatomical continuity with other named potential spaces in the face, such as the prezygomatic and premaxillary spaces.1 In this article, I will share my own experience and injection technique for volumising the deep pyriform space and will explore the anatomy, presenting complaints, injection strategy and challenges posed when treating the space.
The deep pyriform space is an inverted triangular-shaped space bound inferomedially by the depressor septi nasi, the soft tissue insertions on the bony pyriform aperture and post-orbicularis oris…
