Fat Repositioning in Lower Lid Blepharoplasty: General Principles
In young people the eyelid-cheek complex is a single smooth convex profile. Aging causes descent of the globe and pseudoherniation of intraorbital fat, producing a double convex or tear trough deformity on the eyelid profile and a nasojugal groove at the medial aspect of the lower eyelid. With advancing age this depression appears more prominent because of attenuation and descent of the orbicularis oculi and cheek fat, resulting in skeletonization of the orbital area and revealing the topographical contour of the inferior orbital rim. Simple removal of orbital fat can result in a hollow appearance of the lower eyelid.