Rejuvenation of the deep superior sulcus in the eyelid

Nowadays, a number of patients seeking cosmetic surgery for their sunken upper eyelid are increasing. The aim of this study was to provide an overview of the various treatment options for sunken superior sulcus with reported complications and to discuss effective methods for treatment.

In a PubMed search, studies involving patients undergoing correction of sunken superior sulcus with various treatment options were included.

A systematic search revealed twelve articles representing 680 cases that satisfied inclusion criteria. All were case series, and no randomized controlled studies were found. Five reported on augmentation of the deformity with surgery, while hyaluronic acid filler was used in four reports. There was a report attempting to correct the deformity by the microautologous fat grafting. The combined surgical approaches including ptosis correction with upper blepharoplasty and appropriate fat grafting were used in two reports. About 7.2% of patients (49/680) experienced complications, with 4.3% requiring re-operation, while no severe complications were observed.

By careful identification of the clinical features and proper classification of the types of sunken superior sulcus, the treatment plan can be specified.