A Novel Application of Injectable PRF for Superior Sulcus Hollowing

Superior sulcus hollowing is a frequent esthetic concern, commonly managed with synthetic fillers or fat grafts; however, these approaches carry potential risks and costs. Injectable platelet-rich fibrin (i-PRF), an autologous regenerative biomaterial, has shown promise in dermatologic and dental applications, but its use for periocular volume restoration remains unexplored.

To evaluate the efficacy, safety, and patient satisfaction of i-PRF injections for the correction of superior sulcus hollowing.

This single-center retrospective study included 24 eyes of 12 patients treated with i-PRF between 2021 and 2024. Sulcus depth was measured at baseline and at 3 and 6 months posttreatment. Subjective satisfaction was assessed using a binary scale. i-PRF was prepared using a low-speed centrifugation protocol and injected suborbicularis in three sessions spaced 1 week apart.

A significant reduction in superior sulcus depth was observed from baseline to 3 months (13.3 ± 2.8 mm to 9.2 ± 3.7 mm; p = 0.002), followed by mild regression at 6 months (10.5 ± 3.3 mm). Patient satisfaction was high, with 18 out of 24 eyes (75%) reporting favorable outcomes at 3 months. No adverse effects were recorded.

This first clinical report of i-PRF for upper eyelid hollowing suggests that it may serve as a safe, autologous, and minimally invasive alternative for superior sulcus volume restoration. Further prospective studies with standardized outcome measures are warranted to validate these findings.