Orbitofacial regeneration with fully cohesive hyaluronic acid in a patient with post-enucleation orbitofacial sequelae secondary to retinoblastoma: case report

Rehabilitation of orbitofacial defects in patients who have undergone enucleation for ocular neoplasms remains a reconstructive challenge, particularly when volume loss, impaired eyelid support, and midface contour irregularity coexist. Hyaluronic acid biomaterials may provide a minimally invasive complement to optimize aesthetic and functional outcomes. We present the case of a 21-year-old female patient with a history of right ocular enucleation for retinoblastoma in childhood, without an orbital implant, with orbital volume deficit, facial asymmetry, and infraorbital depression. Real-time ultrasound-guided infiltration was performed using Hyaluronic Acid Fully Cohesive Filler (HA-FC) and highly concentrated cooperative hybrid complexes of high- and low-molecular-weight HA (HCHCCs), distributed across the orbital rim, malar region, and infraorbital compartments according to the reconstructive objectives of each product. A single session was performed; no complications or reinjection were reported through June 2026, approximately seventeen months later. This case report suggests that the selective use of ultrapure hyaluronic acid, applied under ultrasound guidance within an interdisciplinary framework, may serve as a complement to reconstructive surgery in complex post-oncological sequelae.