Upper Eyelid Filling With or Without Surgical Treatment.

[BACKGROUND] The upper eyelid of young people is characterized by a proper fullness and projection. Aging eyes show upper eyelid volume loss, symmetric or asymmetric hollowing with too much upper lid showing, dermatochalasis with skin excess. While in the past blepharoplasty surgery was the only approach used to improve eye appearance in the last years, hyaluronic acid (HA) filling of the upper eyelid area has been found very effective in reaching good eye rejuvenation and use of traditional surgical techniques can be limited.

[METHODS] A total of 154 patients were enrolled in this study to improve eye appearance. One hundred twenty-eight patients were treated with HA injections in the upper eyelid only, 21 patients underwent surgical treatment followed by HA injections to ensure full correction, and 5 patients underwent blepharoplasty surgery only. The correct approach has been evaluated on the basis of standardized criterion.

[RESULTS] Twelve-month clinical follow-up was used to evaluate the results and the degree of patient satisfaction was high. The results are very lasting and no modifications after 2 years are common.

[CONCLUSIONS] HA filling is an effective means to rejuvenate the upper eyelid and in several cases it is the only approach able to restore the proper fullness of the upper eyelids. Surgical techniques should be used in the presence of dermatochalasis with excess skin. HA injections in the upper eyelid are easy to perform but it is important to use the correct technique and follow proper indications. This method is a manageable, lasting, and low-cost treatment.

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