Send to

Choose Destination
Ophthalmic Plast Reconstr Surg. 2016 Jul-Aug;32(4):310-2. doi: 10.1097/IOP.0000000000000696.

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

Author information

Division of Oculoplastic and Reconstructive Surgery, Department of Ophthalmology, UT Southwestern Medical Center, Dallas, Texas, U.S.A.



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.


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.


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.


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.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center