Periocular hyaluronic acid fillers: applications, implications, complications

Area of Science:

• Oculofacial plastic surgery
• Dermal fillers
• Aesthetic medicine

Background:

• Hyaluronic acid (HA) fillers are widely used for periocular rejuvenation due to instant results and minimal downtime.
• Their use is increasing for both functional and aesthetic indications in the sensitive periocular region.
• Successful outcomes depend on careful patient, product, and procedural selection.

Purpose of the Study:

• To review current understanding of principal complications associated with periocular hyaluronic acid filler injections.
• To discuss the management strategies for these complications.

Main Methods:

• Literature review of current understanding and recent findings on periocular hyaluronic acid filler complications.
• Analysis of the efficacy and limitations of current treatment modalities, including hyaluronidase.

Main Results:

• Hyaluronic acid fillers, though biodegradable, can exhibit prolonged presence and migration in the periocular area.
• Delayed-onset inflammatory reactions can occur due to contamination or immune stimulation.
• While minor vascular occlusions are noted, blindness is rare; hyaluronidase may treat some complications but its efficacy in retrobulbar embolism is debated.

Conclusions:

• Hyaluronic acid fillers are a valuable tool for oculofacial plastic surgeons, with rising use in aesthetic procedures.
• A comprehensive understanding of anatomy, safe injection techniques, and complication management is crucial for safe and effective use.
• Oculofacial plastic surgeons are well-positioned to lead in the clinical application of these treatments.