Study Could Transform Baggy Eye SurgeryLiveScience

(Aug. 26) - As we age, our eyes inevitably take on a baggy look. Now scientists think they know why.
Fat in the eye socket expands.
The finding could prove useful to the growing number of people not satisfied with the natural look.
Eyelids are not just extraneous flaps of skin. They are crucial for protecting the eye from debris and damage. The eye and eyelid are so connected that the pressure of the eyelid on the eyeball may cause one of the most common vision problems, researchers learned in 2006. Not something you want to muck around with.
Yet eyelid surgery, top or bottom, is more common than you might think. Nearly 241,000 U.S. residents had it performed last year, putting it in the top four among surgical cosmetic procedures performed.
Most of these surgeries don't remove any fat, however. They just move it around or, in a more invasive move, tighten the muscle that surrounds the eye or tighten the ligament that holds the eyeball in place. No data indicated this was the right approach, the researchers point out in the September 2008 issue of the Journal of Plastic and Reconstructive Surgery.
"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 the study's lead researcher 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, Darcy said.