The Asian lower eyelid: a comparative anatomic study using high-resolution magnetic resonance imaging

Area of Science:

• Ophthalmic Plastic Surgery
• Facial Anatomy
• Medical Imaging

Background:

• Asian eyelids, both upper and lower, often appear fuller than those of white individuals.
• Previous studies attributed upper eyelid fullness to preaponeurotic and brow fat extension.
• The anatomical basis for lower eyelid fullness in Asians remained less understood.

Purpose of the Study:

• To investigate and compare the anatomical differences in the lower eyelids of Asian and white individuals.
• To identify specific fat pad locations and projections contributing to lower eyelid morphology.

Main Methods:

• High-resolution magnetic resonance imaging (MRI) was utilized.
• 24 normal Asian and white lower eyelids were analyzed.
• Detailed evaluation of orbital fat projection and location relative to anatomical landmarks.

Main Results:

• Orbital fat projected more anteriorly in all studied Asian lower eyelids compared to white lower eyelids.
• In Asian lower eyelids lacking defined creases, orbital fat extended superiorly to the tarsus border.
• Suborbicularis oculi fat location showed no significant difference between Asian and white lower eyelids.

Conclusions:

• The fuller appearance of the Asian lower eyelid is primarily due to anteriorly projected orbital fat.
• This anterior projection is a key anatomical difference not observed in white lower eyelids.
• While partly analogous to upper eyelid anatomy, lower eyelid fat distribution presents unique ethnic variations.