Abstract
BACKGROUND: Baggy eyelids, formed by intraorbital fat herniation in the lower eyelids, are a sign of aging observed in the midface. This study aimed to identify the cause of baggy eyelids by evaluating the relationship between orbicularis oculi muscle thickness, orbital fat prolapse length, and age using multidetector row computed tomography (MDCT). METHODS: The 34 patients in the study ranged in age from 20 to 79 years. The patients were divided into three age groups: 20-29 years, 30-54 years, and 55-79 years. Orbicularis oculi muscle thickness and orbital fat prolapse length were measured using reconstructed computed tomography (CT) images. RESULTS: The orbicularis oculi muscle was found to be significantly thinner in the oldest group. Likewise, orbital fat prolapse was found to be significantly more prominent in the oldest group. A strong and significant negative correlation was found between orbicularis oculi muscle thickness and orbital fat prolapse length (r = -0.78; P < 0.001) and between orbicularis oculi muscle thickness and age (r = -0.77; P < 0.001). A strong and significant positive correlation was found between orbital fat prolapse length and age (r = 0.78; P < 0.001). CONCLUSIONS: The use of MDCT provides insight into the detailed changes associated with aging that take place within the lower eyelids. This study objectively demonstrated that the major factors associated with baggy eyelids include orbicularis oculi muscle thickness, orbital fat prolapse length, and age. Decreased orbicularis oculi muscle thickness leads to the orbital fat prolapse.