Why Do Our Lower Eyelids Sag?

• Posted on: Mar 15 2018
• By: Damon Chandler

Everyone pretty much dislikes his or her lower eyelids as we age. They become baggy and puffy, and they often make us look much older than we may be. It’s easy to assume this is simply a result of Father Time and the slackening of our support ligaments and muscle tissue.

But a study performed a few years back at UCLA found the culprit — fat — and not for the reasons often assumed.

Popular procedure

Blepharoplasty (Eyelid surgery), or Eye Lift, is a specialty of Dr. Chandler.  Eyelid lifting is one of the most popular cosmetic surgeries performed, with over a quarter of a million Americans opting to rejuvenate their eyes every year. Patients can have eyelid surgery on the upper eyelids, lower eyelids, or both.

The study

The UCLA study concerned only the lower eyelid and the cause of bagginess with aging. To determine the cause, the study looked at magnetic resonance imaging (MRI) from 40 subjects (17 males and 23 females) between the ages of 12 and 80. The findings showed that the size of the lower eyelid tissue increased with age. Why? The largest contributor was an increase in fat.

The study’s lead author, Dr. Sean Darcy, discussed the findings, “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.” Dr. Darcy is a research associate in the division of plastic and reconstructive surgery at the David Geffen School of Medicine at UCLA, and he is a plastic surgery resident at UC Irvine.

Instead of a weakened ligament allowing fat to leak out and increase eyelid bags, the study found that there is an increase in fat with age. The study claims that it is this increase in fat that causes the baggy lower eyelid, more so than a weakened ligament. The study went on to say that, although there is the reticence to remove fat from the lower eyelid, instead usually repositioning it, surgeons should also look at the amount of fat present. The study said that there isn’t any data indicating that the muscles and ligaments that surround the eye and hold it in place necessarily weaken or change with age.

“Our findings may change the way some plastic surgeons treat baggy eyes,” commented the co-author of the study, Dr. Timothy Miller, professor and chief of plastic surgery at the Geffen School of Medicine. He pointed out that tightening the ligament that holds the eyeball in place or tightening the surrounding muscles may not be as necessary as has been thought in some circles.

Interested in addressing the fat in your lower eyelids? Trust the expertise of Dr. Chandler, who focuses on eyelid surgery. Call Dr. Chandler at his Moorestown office (609) 877-2800 or Jenkintown office (215) 885-6830 to schedule your lower blepharoplasty (eye bag removal) consultation.

Posted in: Blepharoplasty, Eyelid Bags