Why do we get baggy, saggy eyes as we age? There are many theories, but UCLA researchers have finally figured it out. It's caused by fat expansion in the eye socket.

Led by 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, the team examined the anatomy of 40 people to figure out what happens to the lower eyelid with age. They studied MRIs of 17 men and 23 women between the ages of 12 and 80. They found that the lower eyelid tissue increased with age and that the largest contributor to this size increase was fat increase.

Until now it's been thought that baggy eyes were caused not by an increase in fat but rather by the breaking or weakening of the cover--called the orbital septum--that holds the fat in place, causing the fat to slip out. "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."

This has huge implications for how plastic surgery is performed on the upper and lower eyelids and could radically change how the procedure is done. According to a recent report by the American Society of Plastic Surgeons, nearly 241,000 Americans underwent eyelid surgery in 2007, making it one of the top four surgical cosmetic procedures performed.

Currently, many plastic surgeons performing procedures to treat baggy eyelids do not remove any fat at all. Instead, they move the fat around or do a more invasive procedure by either tightening the muscle that surrounds the eye or tightening the actual ligament that holds the eyeball in place. These procedures are performed despite there being no data indicating that these structures change with age.

The study findings were published in the Journal of Plastic and Reconstructive Surgery.

--From the Editors at Netscape