Filling the Upper Eyelid Sulcus

Shaha,

Based on your age and depth of the upper lid sulcus, I would recommend a very small amount of hyaluronic acid filler. This injection has to be placed very carefully by a trained plastic surgeon. It has been my experience that hyaluronic acid fillers in this location can last 12 to 18 months. Remember, start conservative; you will not be happy with too much filler.

I would not recommend fat grafting as a first step in your case. As you grow older, if the problem worsens, then I would discuss micro-fat grafting.

Hello shaha. Deep, skeletonised upper eye lids will give you a tired look and could also give an impression of aging.

The only option avaialble is to use fat transfer to be able to fill the upper eye lids. Other fillers could be used as well (hyaluronic acide based). This is a very technical procedure and it has to be done very carefuly to avoid bumps in this area with very thin skin. A retrograde injection technique has to be done to avoid injection into a blood vessel which could lead to serious morbidity in this area. Hope that helps! 

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