VOLUMIZING HYALURONIC ACID FILLER AS TEMPORARY TISSUE EXPANDER IN LOWER EYELID CICATRICIAL ECTROPION

We describe the treatment of lower eyelid cicatricial ectropion in a 24 year old male using volumizing hyaluronic acid (HA) filler. One milliliter of Juvederm Voluma was injected directly under the skin in each lower eyelid to create a large bubble.  The filler was dissolved with hyaluronidase (750 I.U. / side) 5 months later, achieving an excellent and stable functional and cosmetic result. There was a 2.4 mm improvement in MRD-2 with the filler in place which decreased to 1.72 mm at 6 months after filler dissolution with hyaluronidase. This resulted in complete resolution of the signs and symptoms of corneal exposure. To date, there have been reports of low density HA injection for the treatment of cicatricial ectropion in elderly patients as well as infants with lamellar ichthyosis. In these cases the HA was injected and left in place to dissolve itself.  Our case is the first report of a HA with high G’ properties injected directly under the skin followed by complete dissolution with hyaluronidase once the tissue expansion took place.