ABSTRACT
Facial changes due to aging are primarily a result of atrophy of body tissues, particularly of the skin, fat, muscle, and their associated connective tissue attachments. Corresponding histological changes include a flattened epidermal-dermal junction, loss of elastic fibers, and decreased collagen fibers (1). There are numerous structural and dynamic changes that the different regions of the aging face undergo. Aging-related changes of the eyelids are of particular concern to most people because the eyes are the central area of focus during human interaction and conversation. Common clinical manifestations of aging eyelids include primarily the formation of periocular rhytids and upper eyelid skin redundancy (Fig. 1). Other signs of the aging eyelid include laxity in the preseptal lid anatomy, including skin and orbicularis muscle, and weakening of the orbital septum, both of which allow prolapse of orbital fat. Furthermore, upper eyelid ptosis, horizontal lower eyelid laxity, and midfacial descent all contribute to the aging appearance of the periocular and midface area (Table 1).
