title: Use of hyaluronic Acid gel for upper eyelid filling and contouring.
abstract: OBJECTIVE
  To describe the use of hyaluronic acid gel for upper eyelid filling, contouring, and rejuvenation.
  
  
  METHODS
  In this consecutive, retrospective, interventional case series, standard serial puncture injections with preperiosteal placement of filler were administered at the superior orbital rim. Outcome measures included classification of upper eyelid volume deficiency as I) medial A-shaped hollow, II) generalized hollow, III) postblepharoplasty volume loss, and IV) upper eyelid hooding with subbrow volume deflation; volume of filler used; masked, independent assessment of pretreatment and posttreatment photographs; patient satisfaction; and complications.
  
  
  RESULTS
  Twenty-seven patients were included with a mean follow-up of 13 months. More than 85% were white women with a mean age of 51 years (range, 24-65 years). Five patients were classified as type I, 8 as type II, 11 as type III, and 3 as type IV. The mean volume of filler used was 0.4 ml/eyelid (range, 0.1-1 ml). Photographic assessment showed improved static upper eyelid contour in 23 patients (85%), little change in 3 patients (11%), and deterioration in 1 patient (4%). Twenty-six patients (96%) were satisfied with the treatment, although 5 (19%) requested additional filler and 1 patient underwent dissolution within 3 months. Two of the 3 type IV patients still required blepharoplasty/ptosis surgery. All patients developed mild bruising and swelling but no discoloration or lumpiness.
  
  
  CONCLUSIONS
  Hyaluronic acid filler is an effective means of rejuvenating the upper eyelid and is particularly successful in patients with medial/generalized upper eyelid hollowing, or significant postblepharoplasty upper eyelid show. A blepharoplasty/brow lift/ptosis procedure is still frequently required for hooding due to subbrow deflation (type IV).
authors.affiliation: Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, United Kingdom.
authors.forename: Ana M S
authors.initials: AM
authors.lastname: Morley
authors.forename: Mehryar
authors.initials: M
authors.lastname: Taban
authors.forename: Raman
authors.initials: R
authors.lastname: Malhotra
authors.forename: Robert A
authors.initials: RA
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D000368:Aged; D003357:Cosmetic Techniques; D005141:Eyelid Diseases / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005782:Gels / Q000008:administration & dosage*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012060:Rejuvenation; D012189:Retrospective Studies; D015595:Skin Aging / Q000187:drug effects* / Q000502:physiology; D055815:Young Adult
chemical_list: D005782:Gels; D006820:Hyaluronic Acid