Hyaluronic Acid Gel Injection for Multiple Eyelid Folds in Asian Eyelids: A Novel Approach

Diana Tamboli, Ronald Mancini

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Purpose: Upper eyelids of the Asian population have several unique anatomical characteristics that result in the characteristic absence of a native eyelid fold; however, 40% to 60% of the Asian population do exhibit a naturally occurring fold. Aging-Associated soft tissue atrophy and loss of skin elasticity can lead to periorbital volume loss and subsequent development of multiple eyelid folds in patients previously with a native single-fold. The authors describe a nonsurgical technique for the management of multiple eyelid folds in Asian patients using hyaluronic acid gel (HAG) injection. Methods: In this retrospective review, 6 upper eyelids of 5 Asian patients who underwent HAG injection for multiple eyelid folds were identified. Patients were injected with HAG superior to the native eyelid fold in a superficial plane just deep to the orbicularis oculi muscle and in the suborbicularis oculi plane of the superior sulcus. Results: Five Asian patients with prior history of a single naturally occurring upper eyelid fold who developed age-related unilateral multiple eyelid folds underwent injection with HAG. All patients tolerated the procedure well and without complication. Restoration of a single-fold with bilateral upper eyelid symmetry was achieved successfully in all patients. Conclusions: Multiple eyelid folds may occur in Asian patients with an established naturally occurring single eyelid fold as a result of periorbital volume loss. HAG injection in the periorbital region provides a nonsurgical solution to restore volume and reform a single eyelid fold.

Original languageEnglish (US)
Pages (from-to)310-312
Number of pages3
JournalOphthalmic Plastic and Reconstructive Surgery
Issue number4
StatePublished - Aug 1 2016

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology


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