The volumetric change of orbital fat with age in Asians

Lower eyelid prominence occurs as an aging process. Several causes of age-related lower eyelid prominence including herniated excessive intraorbital fat or fat atrophy, weakening of supporting components, and globe descent have been proposed. However, actual occurrence of excessive intraorbital fat herniation is still controversial. We measured volume of total orbital fat (OF) and fat anterior to the inferior orbital rim (IORF) using computed tomography (CT) to evaluate volumetric change of orbital fat with age in Asians. A total of 130 patients (65 men and 65 women) were evaluated, and volumes of OF and IORF were measured. OF and IORF volumes increased until the 60 years of age, and then decreased in both male and female groups. IORF/OF ratio increased with age, and, unlike fat volume, there was no decline after 70 years of age. Increase of orbital fat volume contributed to lower eyelid prominence. Reduction of anterior orbital fat volume could improve age-related lower eyelid prominence, and conservative fat excision in lower blepharoplasty can be useful in management of lower eyelid prominence.