We gratefully acknowledge the opportunity to address the concerns raised in the letter and to clarify specific aspects of our study.1 We also extend our sincere thanks to the authors for their interest in our work and for taking the time to provide their thoughtful observations.
The lesion was located in the medial part of the tear trough region and demonstrated a firm consistency on palpation. During surgical excision, a subciliary incision was made, and dissection was carried out between the orbicularis oculi muscle and the orbital septum to expose the inferior orbital rim. The mass was found to be attached to the periosteum; therefore, a periosteal incision was performed. The lesion was not entirely located anterior to the inferior orbital rim surgically, as it extended into the inferior orbital region. The mass was removed as a single piece (en bloc). Evidence of intraorbital extension was observed in the right orbit on the coronal section of the magnetic resonance imaging of the same patient (Figure 1).
Despite repeated inquiries during the initial ophthalmic examination, the patient consistently denied any history of filler injection; this denial was not due to forgetfulness. Therefore, we highlighted the patient’s denial in the title. It is important to clarify that the patient’s denial does not imply the absence of filler but rather a refusal to acknowledge previous filler injection. Upon further discussion, the patient admitted to having received bilateral hyaluronic acid filler injections in the lower eyelids approximately 10 years prior but chose not to disclose this information initially because the procedure was performed without family consent.
In summary, we sincerely appreciate the considerable interest shown in our article.
