Applied Anatomy of the Lower Eyelid

Lower eyelid function and appearance depend on the complex anatomic relationship between the soft tissue lamellae, supportive tarsoligamentous sling, and bone. Aging in the lower lid area may be caused by changes in the anterior lamella (skin and orbicularis oculi muscle), middle lamella (orbital septum and lower lid fat pads), posterior lamella (tarsus, lower eyelid retractors, and conjunctiva), tarsoligamentous sling (lateral retinaculum), or any combination of the previously described.