Why do eyelids sag with age? New study answers mystery

August 26, 2008
A UCLA study finds that lower baggy eyelids are caused by fat expansion in the eye socket. Credit: American Society for Aesthetic Plastic Surgery

Many theories have sought to explain what causes the baggy lower eyelids that come with aging, but UCLA researchers have now found that fat expansion in the eye socket is the primary culprit. As a result, researchers say, fat excision should be a component of treatment for patients seeking to address this common complaint.

The study, published in the September issue of the peer-reviewed Journal of Plastic and Reconstructive Surgery, is the first to examine the anatomy of multiple subjects to determine what happens to the lower eyelid with age. It is also the first to measure what happens to the face with age using high-resolution magnetic resonance imaging (MRI).

"A common treatment performed in the past and present is surgical excision of fat to treat a 'herniation of fat' — meaning that the amount of fat in the eye socket does not change but the cover that holds the fat in place, the orbital septum, is weakened or broken and fat slips out," said lead author Dr. Sean Darcy, a research associate in the division of plastic and reconstructive surgery at the David Geffen School of Medicine at UCLA and a plastic surgery resident at the University of California, Irvine. "This orbital septum weakening or herniation-of-fat theory is what most plastic surgeons have been taught.

"However, our study showed there is actually an increase in fat with age, and it is more likely that the fat increase causes the baggy eyelids rather than a weakened ligament," Darcy said. "There have been no studies to show that the orbital septum weakens."

The study looked at MRIs of 40 subjects (17 males and 23 females) between the ages of 12 and 80. The findings showed that the lower eyelid tissue increased with age and that the largest contributor to this size increase was fat increase.

According to a recent report by the American Society of Plastic Surgeons, nearly 241,000 Americans underwent eyelid surgery in 2007, making it one of the top four surgical cosmetic procedures performed.

Currently, many plastic surgeons performing procedures to treat baggy eyelids do not remove any fat at all. They reposition the fat or conduct more invasive tightening of the muscle that surrounds the eye, or they tighten the actual ligament that holds the eyeball in place. These procedures are performed despite there being no data indicating that these structures change with age.

"Our findings may change the way some plastic surgeons treat baggy eyes," said study co-author Dr. Timothy Miller, professor and chief of plastic surgery at the Geffen School. "Our study showed that a component of a patient's blepharoplasty procedure should almost routinely involve fat excision rather than these procedures."

Blepharoplasty refers to surgical rejuvenation of the upper or lower eyelids, or both, depending on the extent of aging or disease. The procedure is usually performed on the lower eyelid because the most common complaint patients have is that their eyes appear tired, puffy or baggy. The surgeon makes external incisions along the natural skin lines of the eyelid to remove the excess fat and improve the contour of the lower eyelid.

"Although baggy lower eyelids are a significant result of aging and fat expansion, there are other factors that can contribute too," Miller said. "We recommend that surgeons evaluate each component and address them accordingly in an individualized approach to blepharoplasty."

The next phase of research will be to perform MRIs of people with baggy eyelids.

Source: University of California - Los Angeles

Explore further: Airline food study provides travelers with the best in-flight food choices

Related Stories

Airline food study provides travelers with the best in-flight food choices

December 7, 2017
There will more than 51 million passengers traveling during this holiday season  (Dec. 15th -Jan 4th) according to trade group Airlines for America . Knowing what are the "best" and "worst" choices is a valuable tool for ...

Most plastic surgeons now use fat grafting as part of facelift surgery

June 29, 2015
In recent years, a large majority of US plastic surgeons have adopted fat grafting techniques as part of their approach to facelift surgery, reports a study in the July issue of Plastic and Reconstructive Surgery, the official ...

Fat preservation better for lower eyelid blepharoplasty

July 14, 2014
(HealthDay)—Fat preservation and grafting techniques have gained popularity in lower eyelid blepharoplasty, according to a surgical pearls piece published online June 26 in JAMA Facial Plastic Surgery.

Freezing fat: What's new in beauty

January 26, 2017
Move over liposuction, the new fad in fat is freezing it.

With liposuction, weight should guide fat removal limits, study finds

September 25, 2015
(HealthDay)—Although there's no magic bullet for weight loss, new research suggests that surgeons may be able to safely remove more fat during liposuction surgery than previously believed.

'Fat grafting' widely used during facelift surgery

July 10, 2015
(HealthDay)—Most U.S. plastic surgeons use a procedure called "fat grafting" to enhance the effects of facelifts, a new study reports.

Recommended for you

The HLF gene protects blood stem cells by maintaining them in a resting state

January 17, 2018
The HLF gene is necessary for maintaining blood stem cells in a resting state, which is crucial for ensuring normal blood production. This has been shown by a new research study from Lund University in Sweden published in ...

Magnetically applied MicroRNAs could one day help relieve constipation

January 17, 2018
Constipation is an underestimated and debilitating medical issue related to the opioid epidemic. As a growing concern, researchers look to new tools to help patients with this side effect of opioid use and aging.

Researchers devise decoy molecule to block pain where it starts

January 16, 2018
For anyone who has accidentally injured themselves, Dr. Zachary Campbell not only sympathizes, he's developing new ways to blunt pain.

Scientists unleash power of genetic data to identify disease risk

January 16, 2018
Massive banks of genetic information are being harnessed to shed new light on modifiable health risks that underlie common diseases.

Blood-vessel-on-a-chip provides insight into new anti-inflammatory drug candidate

January 15, 2018
One of the most important and fraught processes in the human body is inflammation. Inflammatory responses to injury or disease are crucial for recruiting the immune system to help the body heal, but inflammation can also ...

Molecule produced by fat cells reduces obesity and diabetes in mice

January 15, 2018
UC San Francisco researchers have discovered a new biological pathway in fat cells that could explain why some people with obesity are at high risk for metabolic diseases such as type 2 diabetes. The new findings—demonstrated ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.