Bulges of the Skin, Fat, Muscle, and Bone Tissue

  • Raul Loeb


Bulges in the eyelids, better known as baggy eyelids, can give a look of tiredness and/or aging to the face. They are very common occurrences and can exist at almost any age.


Lateral Angle Orbicularis Oculus Orbital Septum Orbicularis Oculus Muscle Scleral Show 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Additional Reading

Skin Bulges

  1. Adamson JE, MccrawJB et al: — Use of the muscle flap in lower blepharoplasty. Plast Reconstr Surg 1979; 63: 359.PubMedCrossRefGoogle Scholar
  2. Backer TJ: Upper blepharoplasty. Clin Plast Surg 1981; 8: 635.Google Scholar
  3. Christ JE: Cleansing eyelids after blepharoplasty. Plast Reconstr Surg 1985; 75: 444.Google Scholar
  4. Converse JM: The Converse technique of the corrective eyelid plastic operation, in Converse JM (ed): Reconstructive Plastic Surgery. Philadelphia WB Saunders Co, 1964.Google Scholar
  5. Courtiss EH: Selection of alternatives in esthetic blepharoplasty. Clin Plast Surg 1981; 8: 739.PubMedGoogle Scholar
  6. Cronin TD: Marginal incision for upper blepharoplasty. Plast Reconstr Surg 1972; 49: 14.PubMedCrossRefGoogle Scholar
  7. Doxanas MT, Serra F et al: Surgical revision of oriental eyelids. Ophthalmic Surg 1985; 16: 657.PubMedGoogle Scholar
  8. Flowers RS: Anchor blepharoplasty, in: Transactions of the Sixth International Congress Plastic Surgery. Paris, Masson et Cie, 1976.Google Scholar
  9. Gonzalez-UlloaM, Stevens EF: Senile eyelid esthetic correction. Proceedings of the 2nd International Symposium on Plastic and Reconstructive Surgery of the Eye and Adnexa, Smith B, Converse JM. (eds). St. Louis, CV Mosby Co, 1967.Google Scholar
  10. Guerra SilvaJ: Aesthetic blepharoplasty, in: Sucena RC: Cirurgia Plastica, São Paulo, Livraria Rocca, vol 2, 1982. (in Portuguese)Google Scholar
  11. Guy CL, Liverett DN: upper and lower blepharoplasty: Standard technique. Clin Plast Surg 1981; 8: 663.PubMedGoogle Scholar
  12. Hinderer U: The aging palbebral and periorbital region. Transactions of the VII Congress of the International Plastic Reconstr Surg, Rio de Janeiro, 1979.Google Scholar
  13. Hornblass A: Ptosis and Pseudoptosis and Blepharoplasty. Clin Plast Surg 1981; 8: 811.PubMedGoogle Scholar
  14. Kaye BL: Two helpful technical aids in blepharoplasty. Plast Reconstr Surg 1983; 71: 714.PubMedCrossRefGoogle Scholar
  15. Klastsky SA, Manson PN: Separate skin and muscle flaps in lowerlid blepharoplasty. Plast Reconstr Surg 1981; 67: 151.CrossRefGoogle Scholar
  16. Loeb R: Technical improvement for palpebral rhitidectomy. Rev Latinoam Cir Plast 1961; 5: 93.Google Scholar
  17. Loeb R: Surgical procedure to avoid paralysis of the occipital belly of the occipito-frontalis muscle in rhytidoplasty. Transactions of the Fourth International Congress of Plastic and Rec. Surgery, Rome, 1967, pp. 1116–1119.Google Scholar
  18. Loeb R: Aesthetic blepharoplasties based on the degree of wrinkling. Plast Reconstr Surg 1971; 47: 33.PubMedCrossRefGoogle Scholar
  19. Loeb R: La hipertrofia del músculo orbicular y su influencia en el relieve de las bolsas palpebrales. Cirurgia Estética, Argentina 1976; 1: pp. 7–8 (in Spanish).Google Scholar
  20. Loeb R: Musculus orbicularis oculy hypertrophy - Different treatments depending on the clinical cases. Abstracts of paper presented during the IX Congress of the ISAPS, New York, 1987.Google Scholar
  21. Mouly R: Cosmetic surgery of the eyelids. Chirurgie 1983; 109: 248. (in French)PubMedGoogle Scholar
  22. Owsley JQ Jr: Blepharoplasty variations, in Goulian D, Courtis EH (eds): Symposium on Surgery of the Aging Face, vol 19. St. Louis, CV Mosby Co, 1978.Google Scholar
  23. Panneton P: The blepharochalasis. Report of 51 cases in the same family. Arch Ophthalmol 1963; 53: 725. (in French)Google Scholar
  24. Parkes M, Fein W et al: — Pinch technique for repair of cosmetic eyelids deformities. Arch Ophthalmol 1973; 89: 324.PubMedGoogle Scholar
  25. Rees TD: In panel discussion on the cosmetic eyelid plastic operation. Proceedings of the 2nd International Symposium on Plastic and Reconstructive Surgery of the Eye and Adnexa, Smith B, Converse JM (eds). St. Louis, CV Mosby Co, 1967.Google Scholar
  26. Rees TD, Tabbal N: Lower blepharoplasty. Clin Plast Surg 1981; 8: 643.PubMedGoogle Scholar
  27. Rees TD: Prevention of ectropion by horizontal shortenning of the lower lid during blepharoplasty. Ann Plast Surg 1983; 11: 17.PubMedCrossRefGoogle Scholar
  28. Rogers BO: An electrocauterization technique for cosmetic blepharoplasty, in: Aesthetic Plastic Surgery, vol II. Gonzales-Ulloa M and Meyer R Piccin, 1987.Google Scholar
  29. Sayoc BT: Blepharochalasis in upper eyelids, including its classification. Am J Ophthalmol 1957; 43: 970.PubMedGoogle Scholar
  30. Shagets FW, Shore JW et al: The management of eyelid laxity during lower eyelid blepharoplasty. Arch Otolaryngol 1986; 112: 729.Google Scholar
  31. Sheen JH: Supratarsal fixation in upper blepharoplasty. Plast Reconstr Surg 1974; 54: 424.PubMedCrossRefGoogle Scholar
  32. Sheehan JE: Plastic Surgery of the Orbit. New York, Macmillan, 1927.Google Scholar
  33. Shirakabe Y, Kinugasa T et al: The double-eyelid operation in Japan: its elolution as related to cultural changes. Ann Plast Surg 1985; 15: 224.PubMedCrossRefGoogle Scholar
  34. Skooc T: Plastic Surgery. Philadelphia, WB Saunders Co, 1975.Google Scholar
  35. Song RY, Song YG et al: Double eyelid operations. Aesthetic Plast Surg 1985; 9: 173.PubMedCrossRefGoogle Scholar
  36. Spira M: Lower blepharoplasty - a clinical study. Plast Reconstr Surg 1977; 59: 35.PubMedCrossRefGoogle Scholar
  37. Stark RB: Blepharoplasty, how I do it. Ann Plast Surg 1978; 1: 58.PubMedCrossRefGoogle Scholar
  38. Stephenson KL: The history of blepharoplasty to correct blepharochalasis. Aesth Plast Surg 1977; 1: 77.Google Scholar
  39. Taylor DP, Salyer KE et al: Protecting the eye during surgery. Plast Reconstr Surg 1986; 77: 684.PubMedCrossRefGoogle Scholar
  40. Toledo LS: Blepharoplasty with Fibrin seal. Transactions VIII International Congress of Plastic and Reconstructive Surgery, Canada, 1983.Google Scholar
  41. Volfley D: Blepharoplasty: The ophthalmologist’s view. Otolaryngol Clin North Am 1980; 13: 237.Google Scholar

Fat Bulges

  1. Bames H: Baggy eyelids. Plast Reconstr Surg 1958; 22: 264.CrossRefGoogle Scholar
  2. Barker DE: Dye injection studies of intraorbital fat compartments. Plast Reconstr Surg 1977; 59: 82.PubMedCrossRefGoogle Scholar
  3. Castanares S: Blepharoplasty for herniated intraorbital fat. Anatomic bases for a new approach. Plast Reconstr Surg 1951; 8: 46.CrossRefGoogle Scholar
  4. Castanares S: Baggy eyelids. Physiological considerations and surgical technique. Transactions of the 3rd International Congress of Plastic Surgery. Excerpta Medica Foundation, 1964.Google Scholar
  5. Castanares S: The lateral fat compartments of the lower eyelid. Aesthetic Plast Surg 1983; 7: 27.PubMedCrossRefGoogle Scholar
  6. Dufourmentel C, Mouly R: Surgical treatment of wrinkles and pouches of the eyelids. Ann Chir Plast 1958; 3: 229. (in French)PubMedGoogle Scholar
  7. Gonzalez-Ulloa M, Stevens EF: The treatment of pal- pebral bags. Plast Reconstr Surg 1961; 27: 381.CrossRefGoogle Scholar
  8. Johnson JB, Hadley RC: The aging face, in Converse JM (ed): Reconstructive Plastic Surgery. Philadelphia, WB Saunders Co, 1964.Google Scholar
  9. Owsley JQ: Resection of prominent lateral fat pad during upper lid blepharoplasty. Plastic Reconstr Surg 1980; 65: 4.CrossRefGoogle Scholar
  10. Pitanguy I, Lessa S et al: Subconjuntival fat hernia- tion. Rev Bras Cir 1975; 65: 151. (in Portuguese)Google Scholar
  11. Pstllakis JM, Albano A: Surgical treatment of wrinkles and eyelid bulkiness. Rev Asoc Med Bras 1976; 22: 97. (in Portuguese)Google Scholar
  12. Putterman AM, Urist MJ: Baggy eyelids - a true hernia. Ann Ophthalmol 1973; 5: 1029.PubMedGoogle Scholar
  13. Rees TD, Dupuis C: Baggy eyelids in young adults. Plast Reconstr Surg 1969; 43: 381.PubMedCrossRefGoogle Scholar
  14. Reidy JP: Swelling of eyelids. Br J Plast Surg 1960; 13: 256.PubMedCrossRefGoogle Scholar
  15. Sachs ME, Bosniak SL et al: Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty. Aesthetic Plast Surg 1986; 10: 111.PubMedCrossRefGoogle Scholar
  16. Schwarz F, Randall P: Conjunctival incision for her- niated orbital fat. Ophthalmic Surg 1980; 11: 276.PubMedGoogle Scholar
  17. Tessier P: The treatment of baggy eyelids through the conjunctival route in young patients, in: Transactions First International Congress of the International Society for Aesthetic Plastic Surgery, Rio de Janeiro, 1972.Google Scholar
  18. Tobin HA: Electrosurgical blepharoplasty: a technique that questions conventional concepts of fat compartmentalization. Ann Plast Surg 1985, 14: 59.PubMedCrossRefGoogle Scholar
  19. Smith JW: Blepharoplasty: Technical details. Aesthetic Plast Surg 1987; 2: 95.Google Scholar

Muscular Bulges

  1. AstonSJ: Skin-muscle flap lower lid blepharoplasty: an easier dissection. Aesthetic Plast Surg 1982; 6: 217.PubMedCrossRefGoogle Scholar
  2. Baker TJ, Gordon HL et al: Upper lid blepharoplasty. Plast Reconstr Surg 1977; 60: 692.PubMedCrossRefGoogle Scholar
  3. Beare R: Surgical treatment of senile changes in the eyelids. The Mclndoe-Beare technique, in: Smith B, Converse JM (eds): Proceedings of the Second International Symposium on Plastic and Reconstructive Surgery of Eye and Adnexa. Edited St. Louis, CV Mosby Co, 1967.Google Scholar
  4. Furnas DW: Festoons of orbicularis muscle as a cause of baggy eyelids. Plast Reconstr Surg 1978; 61: 531CrossRefGoogle Scholar
  5. Furnas DW: The Orbicularis Oculi Muscle. Clin Plast Surg 1981; 8: 687.PubMedGoogle Scholar
  6. Gordon G: Observations upon the movements of the eyelid. Br J Ophthalmol 1951; 35: 339.PubMedCrossRefGoogle Scholar
  7. Kennard DW, Glaser GH: An analysis of eyelid movements. J New Ment Dis 1964; 139: 31.CrossRefGoogle Scholar
  8. Loeb R: Orbicularis oculi muscle hipertrophie and its influence in the projection of palpebral pouches. Cir Estét 1976; 1:1. Buenos Aires. (in Spanish)Google Scholar
  9. LoebR: Necessity for partial resection of the orbicularis oculi muscle in blepharoplasties in some young patients. Plast Reconstr Surg 1977; 60: 178.CrossRefGoogle Scholar
  10. SpinaV, Kamakura L et al: Surgical treatment of wrinkles of the lower eyelids associated with herniation of orbital fat: muscular-cutaneous flap technique. J Int Surg 1969; 52: 400.Google Scholar
  11. Walsh FB, Hoyt WF: Clinical Neuro-Ophthalmology, vol 1, ed 3. Baltimore, Williams, Wilkins, Co, 1969.Google Scholar

Bony Bulges

  1. Lassus C: Osteotomy of superior orbital rim in cosmetic blepharoplasty. Plast Reconstr Surg 1979; 63: 481.PubMedCrossRefGoogle Scholar
  2. Lentilhac JP: Reduction of the supraorbital ridges. A new cosmetic operation?; Personal publication, Paris. (in French)Google Scholar
  3. Rees TD: Postoperative considerations and complications, in: Aesthetic Plastic Surgery. Philadelphia, WB Saunders Co, 1980, p. 536.Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1989

Authors and Affiliations

  • Raul Loeb
    • 1
    • 2
  1. 1.Escola Paulista de MedicinaFederal University of São PauloSão PauloBrazil
  2. 2.International Society of Aesthetic Plastic SurgerySão PauloBrazil

Personalised recommendations