Efficacy and Safety of Hyaluronic Acid Gel Fillers in the Periorbital Region

Purpose: We assessed the indications, efficacy, safety, and durability of hyaluronic acid gel filler injections in the periorbital region. Efficacy was evaluated through subjective patient satisfaction and objective symptom improvement.Methods: We conducted a retrospective analysis of the medical records of patients who underwent periorbital hyaluronic acid gel filler injections between February 2011 and June 2023. Patient demographics, indications for treatment, pre-injection symptoms, post-injection outcomes (including patient satisfaction), complications, and filler durability were collected and analyzed.Results: In total, 125 patients underwent 177 injection sessions. The mean age of patients was 49.0 years, with female predominance (71.2%). The most common indications were lid retraction (26.55%), enophthalmos (22.03%), and tear trough deformity (12.99%). Overall patient satisfaction was high (89.27%), and undercorrection was the primary reason for dissatisfaction (10/177); subsequent injections successfully addressed undercorrection in all patients. Symptom improvement was observed in 94.35% of injections, and 7 cases required surgery for persistent symptoms. Enophthalmos correction was 1.07 mm per injection and 1.15 mm per 1 cc of filler. Lid retraction improved by 1.41 ± 0.82 mm with an average of 0.51 ± 0.36 cc of filler per session. Common complications included pain, bruising, nausea, vomiting, and swelling. The mean filler durability was 46.3 weeks.Conclusions: Lid retraction, enophthalmos, and tear trough deformity were common indications for periorbital hyaluronic acid gel filler injections. Most patients reported symptom improvement and high satisfaction. These findings suggest that periorbital filler injections can be a safe and effective outpatient treatment option for various periorbital conditions.