case_images: PMC11140515_01
case_images: Oblique view of a 52-year-old female patient described in Case 1. (A) Pretreatment photograph and (B) posttreatment photograph. Note the presence of lid-cheek junction edema and blue discoloration of the pretreatment photograph, features that are no longer present in the posttreatment photograph (captured 28 months later).
case_images: ojad102f1.jpg
case_images: PMC11140515_01_ojad102f1.jpg
case_images: ojad102-F1
case_images: She was referred for the evaluation and treatment of eyelid and malar edema (Figure 1 and Video).
case_images: PMC11140515_02
case_images: (A, C) Preoperative front facing and oblique photographs of a 64-year-old female (Case 2) presenting with signs of post-hyaluronic acid recurrent eyelid edema and symptoms including intermittent malar edema. (B, D) One year after a single treatment session of enzymatic degradation of a previously placed hyaluronic acid filler, along with fractionated radiofrequency microneedling and carbon dioxide laser skin resurfacing, there was a resolution of symptoms in addition to clinical aesthetic improvement.
case_images: ojad102f2.jpg
case_images: PMC11140515_02_ojad102f2.jpg
case_images: ojad102-F2
case_images: A 64-year-old female presented with a 3-year history of intermittent, recurrent, and painless edema of her malar region (Figure 2).
case_images: PMC11140515_03
case_images: (A) Full-face photograph of a 54-year-old female prior to post-hyaluronic acid recurrent eyelid edema treatment showing chronic swelling over the orbital rim hollows and malar region. Focused periorbital photographs of the same patient, (B) before and (C) 6 months after treatment with hyaluronidase and fractionated radiofrequency microneedling treatment outlined in Case 3.
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case_images: PMC11140515_03_ojad102f3.jpg
case_images: ojad102-F3
case_images: Therapeutics), 75 units, coupled with simultaneous fractionated RF microneedling (Morpheus-8; InMode) to the midface with the following settings: 1 mm depth and an energy level of 15 and 3 mm depth and energy level of 25. The patient received a total of 100 shots (50 per side; Figure 3).
case_images: PMC11140515_04
case_images: A 58-year-old female with post-hyaluronic acid recurrent eyelid edema was treated with a combination of hyaluronidase, fractionated radiofrequency microneedling, and CO2 laser resurfacing (Case 4). (A, C, E) Bilateral oblique and frontal pretreatment views. (B, D, F) The posttreatment photographs were captured 9 months after treatment.
case_images: ojad102f4.jpg
case_images: PMC11140515_04_ojad102f4.jpg
case_images: ojad102-F4
case_images: The edema was noted to be worse in the mornings and exacerbated by the consumption of salty foods or alcohol (Figure 4).
case_images: PMC11140515_05
case_images: A 49-year-old female with post-hyaluronic acid recurrent eyelid edema was treated with a combination of hyaluronidase injection and fractionated radiofrequency microneedling. (A, C, E) Pretreatment bilateral front facing and oblique views. (B, D, F) The posttreatment photographs were captured 1 year after treatment.
case_images: ojad102f5.jpg
case_images: PMC11140515_05_ojad102f5.jpg
case_images: ojad102-F5
case_images: She reported a history of multiple episodes of HA filler injection to the cheek and orbital rim hollow, at 10 years, 5 years, and 1 year prior to presentation (Figure 5).