Why Do We Get Baggy Eyes?

Research has found that eyes become baggy with age because the fat in the eye socket expands. View full size image

As we age, our eyes inevitably take on a baggy look. Now scientists think they know why.

Fat in the eye socket expands.

The finding could prove useful to the growing number of people not satisfied with the natural look.

Eyelids are not just extraneous flaps of skin. They are crucial for protecting the eye from debris and damage. The eye and eyelid are so connected that the pressure of the eyelid on the eyeball may cause one of the most common vision problems, researchers learned in 2006. Not something you want to muck around with.

Yet eyelid surgery, top or bottom, is more common than you might think. Nearly 241,000 U.S. residents had it performed last year, putting it in the top four among surgical cosmetic procedures performed.

Most of these surgeries don't remove any fat, however. They just move it around or, in a more invasive move, tighten the muscle that surrounds the eye or tighten the ligament that holds the eyeball in place. No data indicated this was the right approach, the researchers point out in the September 2008 issue of the Journal of Plastic and Reconstructive Surgery.

"A common treatment performed in the past and present is surgical excision of fat to treat a 'herniation of fat' — meaning that the amount of fat in the eye socket does not change but the cover that holds the fat in place, the orbital septum, is weakened or broken and fat slips out," said the study's lead researcher 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.

This orbital septum weakening or herniation-of-fat theory is what most plastic surgeons have been taught, Darcy said.

"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."

The researchers looked at detailed MRI images of 40 subjects (17 males and 23 females) between the ages of 12 and 80. The findings showed that the lower eyelid tissue increased with age and that the largest contributor to this size increase was fat increase.

"Our findings may change the way some plastic surgeons treat baggy eyes," said study co-author Dr. Timothy Miller, professor and chief of plastic surgery at the Geffen School. Fat removal should be at least part of the process, the researchers figure.

Or, of course, people could just look the other way.

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