Anatomical Study and Clinical Observation of Retro-orbicularis Oculi Fat (ROOF)

  • Xian Wang
  • Haiping WangEmail author
Original Article Basic Science/Experimental



To study the anatomical location of retro-orbicularis oculi fat (ROOF) in the upper eyelid and to investigate how ROOF affects the appearance of the upper eyelid.


Twenty-eight Chinese hemifacial cadaver specimens were used (14 male cadavers; age range 52–82 years). In 28 hemifaces, the eyelids were dissected from the superficial to deep layers, and the appearance, location, extent, and surrounding tissue of ROOF were observed. Additionally, we observed the relationship between the upper eyelid morphology and ROOF of the upper eyelid in surgical patients who were treated in the plastic surgery department of Tongji Hospital affiliated with Huazhong University of Science and Technology in 2018.


ROOF is a type of fascia adipose tissue that is located in a fat compartment between the muscles (the orbicularis oculi and frontalis muscles) and the orbital septum/frontalis fascia. In patients with hypertrophic ROOF, the upper eyelid appears as a heavy eyelid and as a drooping eyelid. And in patients with atrophic ROOF, the upper eyelid appears as a sunken eyelid.


ROOF is located in the fat compartment between the orbicularis muscle and the orbital septum/frontalis fascia. ROOF covers the entire upper eyelid and appears thinner medially and thicker laterally. It is continuous with the fat under the frontalis muscle and affects the appearance of the upper eyelid. It represents an important factor in upper eyelid surgery.

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Upper eyelid Retro-orbicularis oculi fat (ROOF) Heavy eyelid Sunken eyelid Fat compartment Suborbicularis oculi fat (SOOF) 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights

This article does not contain any studies with human participants or animals that were performed by any of the authors.

Informed Consent

For this type of study, informed consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Department of Plastic Surgery, NO 1095 Jiefang Avenue, Tongji HospitalHuazhong University of Science and TechnologyWuhanChina

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