August 29, 2008
Accumulated Fat Causes Saggy Lower Eyelids

Too much fat causes lower eyelids to sag with age. This suggests mini-liposuction will work to reverse and prevent it.

Many theories have sought to explain what causes the baggy lower eyelids that come with aging, but UCLA researchers have now found that fat expansion in the eye socket is the primary culprit.

As a result, researchers say, fat excision should be a component of treatment for patients seeking to address this common complaint.

The study, published in the September issue of the peer-reviewed Journal of Plastic and Reconstructive Surgery, is the first to examine the anatomy of multiple subjects to determine what happens to the lower eyelid with age. It is also the first to measure what happens to the face with age using high-resolution magnetic resonance imaging (MRI).

"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 lead author 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.

"However, our study showed there is actually an increase in fat with age, and it is more likely that the fat increase causes the baggy eyelids rather than a weakened ligament," Darcy said. "There have been no studies to show that the orbital septum weakens."

The study looked at MRIs of 40 subjects (17 males and 23 females) between the ages of 12 and 80. The findings showed that the lower eyelid tissue increased with age and that the largest contributor to this size increase was fat increase.

It is surprising to me that this explanation was only figured out in the year 2008.

Share |      Randall Parker, 2008 August 29 07:19 AM  Aging Mechanisms

Ned said at August 29, 2008 9:33 AM:

The operation to correct this hideous deformity is technically known as a "bag job." I have a friend who is a very skillful eye surgeon. She began scheduling a few of these on her surgery days to fill in the gaps between the big cases. I guess you know what happened. Pretty soon she was doing only bag jobs. These elective cases were all cash up front - no haggling with Medicare or some other third party for a discounted payment. Too bad - she's really a good eye surgeon, but I guess that shows where our society places its priorities.

Brett Bellmore said at August 30, 2008 7:28 AM:

What we really need is a technique for delivering drugs globally to the system, and making them work locally. Maybe something involving compounds sensitive to terahertz radiation... We've got some pretty good 3D scanning technologies, but we really need the capacity to effect tissues in 3D to go along with them. That would substitute for carving up people with knives...

rob said at September 3, 2008 6:50 AM:

Randall, I would do this myself if I were smarter and harder-working. But I'm not. Is the information available to find the relative price changes between insurance and welfare-covered medical treatments vs. uncovered treatments? For example, Propecia costs ~$30/month, and there's no generic version sold in the US. Is that because of economies of scale and easy synthesis, or because Merck and Propecia users can't force third parties to pay for it?

Anecdotal evidence has it that cosmetic surgery keeps getting cheaper, but other factors besides private profit and socialized costs might be very important. One that comes to mind is physician priorities. Perhaps there was little innovation in cosmetic surgery, say 20 years ago, because few physicians were interested in it.

Another factor to consider in the cost of medicine is delayed payments: money now is worth more than money later. If I pay the same price at time of treatment vs. an insurer paying X months later, it's more profitable to the hospital/physician.

I wish we could get an a really bright engineer as president. They are on average much better at understanding large, inter-connected systems than lawyers.

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