Periorbital Filler Injection

The periocular subunit is essential for social communications and emotional expression. With aging, bone reabsorption occurs, mainly in the orbit, periorbital, malar, submalar, and mandibular areas. This reabsorption leads to volume loss in the deep supraperiosteal layer, particularly in the lateral and medial suborbicularis oculi fat, creating a tired, sad, angry appearance. As medical and surgical knowledge on facial aging has evolved, there has been a shift from isolated volume-reducing interventions to volume-replacement techniques for periorbital aging. The minimally invasive and office-based nature of fillers has contributed to their growing popularity, making them one of the most commonly performed cosmetic oculoplastic procedures. This chapter provides an overview on appropriate knowledge of periocular anatomy, indications and contraindications of periorbital filler injection, characteristics of fillers, proper injection technique, and management of potential complications. At the end of the chapter, we aim to provide a brief overview on the use of mesogel at the periorbital regions.