- The major cause of bagginess around the eyes is the presence of the fat that normally surrounds the eye, bulging into the eyelid area.
This is usually described as fat herniation but some doctors believe that it is a pseudoherniation, not due to a breaking through of the fat at all. They believe it is due to thinning or attenuation of the orbital septum, the thin layer which separates the orbit from the subcutaneous tissue.
- Even though this layer may be thin, it is not recommended that it is tightened. This may cause scar that can contract and lead to an ectropion or pulling down of the lower eyelid.
The surgeon must be careful not to over resect the fat pads because this may lead to a deep set, hollow look to the eyelids
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