2020–2021 BCSC Basic and Clinical Science Course™
7 Oculofacial Plastic and Orbital Surgery
Part II: Periocular Soft Tissues
Chapter 13: Facial Rejuvenation
Nonsurgical Facial Rejuvenation
Soft-Tissue Dermal Fillers
Many formulations of fillers are available for nonsurgical facial rejuvenation. Bovine collagen was initially approved by the FDA in 1995. However, its use required patch skin testing for possible allergic response. With the increased use of hyaluronic acid fillers derived from bacteria, bovine collagen usage has since declined. Hyaluronic acid fillers do not require allergy testing and have been approved by the FDA for the treatment of facial wrinkles or folds such as the nasolabial folds (Fig 13-1), for lip augmentation, and to correct age-related volume loss in the cheek area. Off-label usage of hyaluronic acid fillers for the periocular region (Fig 13-2) has been described extensively in the literature, but these fillers must be used with care. Complications from intravascular injection, including regional soft-tissue necrosis and central retinal artery occlusion, have been reported. In central retinal artery occlusion, retrograde embolization follows inadvertent high-pressure injection into an artery (see Chapter 9, Fig 9-9).
-
Goldberg RA, Fiaschetti D. Filling the periorbital hollows with hyaluronic acid gel: initial experience with 244 injections. Ophthalmic Plast Reconstr Surg. 2006;22(5):335–341.
-
Peter S, Mennel S. Retinal branch artery occlusion following injection of hyaluronic acid (Restylane). Clin Exp Ophthalmol. 2006;34(4):363–364.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.