Aging eyes are characterized by the development of wrinkles, fine lines, drooping skin, midface hollowing, and eyelid bags. These changes make patients look tired and angry. The bulging of the lower eyelids occurs as the tissue wall (orbital septum) that holds the fat in the orbit begins to weaken and stretch. Traditional blepharoplasty attempts to address this bulge by reducing the fat.
This approach to treating the aging eyes reduces the bulge, however, it can produce two unwanted effects. The first is an unmasking of midface hollowing that was masked by the fullness of the bulging lower eyelids. The second occurs as the face continues to age. Over time, the orbital fat begins to lose volume. This produces hollowing around the eyes. If the fat is reduced during a blepharoplasty, this hollowing is accelerated. This leaves the patient with a skeletal look that is difficult to correct.