# A Novel Application of Injectable PRF for Superior Sulcus Hollowing

## TL;DR

Injectable PRF is a safe and effective alternative for correcting upper eyelid hollowing, showing significant improvement with minimal risk.

## Contribution

First clinical evaluation of injectable PRF for superior sulcus hollowing.

## Key findings

- Significant reduction in superior sulcus depth at 3 months post-treatment.
- 75% of patients reported favorable outcomes at 3 months.
- No adverse effects were recorded during the study.

## Abstract

Superior sulcus hollowing is a frequent esthetic concern, commonly managed with synthetic fillers or fat grafts; however, these approaches carry potential risks and costs. Injectable platelet‐rich fibrin (i‐PRF), an autologous regenerative biomaterial, has shown promise in dermatologic and dental applications, but its use for periocular volume restoration remains unexplored.

To evaluate the efficacy, safety, and patient satisfaction of i‐PRF injections for the correction of superior sulcus hollowing.

This single‐center retrospective study included 24 eyes of 12 patients treated with i‐PRF between 2021 and 2024. Sulcus depth was measured at baseline and at 3 and 6 months posttreatment. Subjective satisfaction was assessed using a binary scale. i‐PRF was prepared using a low‐speed centrifugation protocol and injected suborbicularis in three sessions spaced 1 week apart.

A significant reduction in superior sulcus depth was observed from baseline to 3 months (13.3 ± 2.8 mm to 9.2 ± 3.7 mm; p = 0.002), followed by mild regression at 6 months (10.5 ± 3.3 mm). Patient satisfaction was high, with 18 out of 24 eyes (75%) reporting favorable outcomes at 3 months. No adverse effects were recorded.

This first clinical report of i‐PRF for upper eyelid hollowing suggests that it may serve as a safe, autologous, and minimally invasive alternative for superior sulcus volume restoration. Further prospective studies with standardized outcome measures are warranted to validate these findings.