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Diaspro et al. Plast Aesthet Res 2020;7:62 Plastic and
DOI: 10.20517/2347-9264.2020.143 Aesthetic Research

Review Open Access

Hyaluronic acid for lower eyelid and tear trough
rejuvenation: review of the literature

Alberto Diaspro , Giuseppe Sito 2
1
1 Department of Maxillofacial and Facial Plastic Surgery, Rigeneralab Centre for Regenerative Medicine, Turin 10134, Italy.
2 Department of Aesthetic Surgery and Medicine, Pegaso University, Naples 80121, Italy.
Correspondence to: Dr. Alberto Diaspro, Department of Maxillofacial and Facial Plastic Surgery, Rigeneralab Centre for
Regenerative Medicine, Corso Unione Sovietica 159/a, Turin 10134, Italy. E-mail: info@albertodiaspro.com
How to cite this article: Diaspro A, Sito G. Hyaluronic acid for lower eyelid and tear trough rejuvenation: review of the literature.
Plast Aesthet Res 2020;7:62. http://dx.doi.org/10.20517/2347-9264.2020.143
Received: 30 Jun 2020 First Decision: 10 Aug 2020 Revised: 23 Aug 2020 Accepted: 23 Sep 2020 Published: 6 Nov 2020

Academic Editor: Wen-Guo Cui Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Periorbital aging has been identified as one of the most important aesthetic concerns of the face, so that lower
eyelid rejuvenation has become a topic of major interest. Not every patient requires surgical blepharoplasty
and selected lower eyelid problems and defects due to the aging process have been treated with hyaluronic
acid (HA) gel injections since 2004. With this as the premise, the current work serves to review the published
medical literature on the use of HA for lower eyelid and tear trough rejuvenation. A PubMed search was carried
out in May 2020 using the search terms: “Tear trough [and] HA [and] filler”; “Tear trough [and] HA”; “HA [and]
lower eyelid [and] filler”; “HA [and] lower eyelid”. A large number of relevant studies were identified. Surgical
management remains the gold standard for lower eyelid rejuvenation but increasingly, non-surgical correction
of selected deformities with HA injection may provide a reliable option based on the available evidence. Further,
prospective randomized controlled studies and systematic reviews of the literature are nevertheless desirable
and a standardized, widely accepted grading system of the deformity and its treatment outcomes will allow us to
codify this procedure better.

Keywords: Eyelid, tear trough, hyaluronic acid, rejuvenation

INTRODUCTION
The eyes are located in the centre of the face and are crucial to its aesthetic appeal. It is therefore of
major concern to patients. Because minor changes to the eyes can yield dramatic results, many aesthetic

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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