To evaluate differential changes in the central and nasal fat pads of the upper eyelid associated with aging and the effect of body mass index in Koreans.

Using a standardized scale, the volume grade of the central and nasal fat pads was graded from 0 to 3 (0 for depressed, 1 for flat, 2 for mildly protruded, and 3 for markedly protruded) in normal adults, consisting of 20 males and 20 females from 30 years of age to 80 years of age. The body mass index was calculated for every patient through interviews using their height and weight. Statistical evaluations correlating age and body mass index with central and nasal fat pad changes were performed. Statistical evaluations correlating age with fat pad changes except for the effect of body mass index were performed.

Except for the effect of body mass index, the central fat pad increased (r = -0.176, p = 0.007) and nasal fat pad decreased (r = 0.252, p < 0.001) with aging, which was statistically significant.

With aging, the central fat pad increases and nasal fat pad decreases in the upper eyelid. Clinically, this finding has implications in cosmetic and functional upper eyelid blepharoplasty. In addition, the results may be useful to determine whether to conserve or remove the fat as well as the amount of fat removal during upper blepharoplasty.