Basic Consideration for Facial Aging: Age-related Changes of the Bony Orbit and Orbicularis Oculi Muscle in East Asians.

BACKGROUND
Age-related changes in the periocular areas are mainly caused by anatomical changes of the bony orbit and orbicularis oculi muscle (OOM). To achieve effective rejuvenation, it is necessary to understand these anatomical changes according to age.


OBJECTIVES
We analyzed the configuration of the bony orbit and OOM using computed tomography (CT) and evaluated the effects of aging on these structures.


METHODS
A total of 220 orbits and OOMs of 110 Japanese participants (55 males, 55 females) aged 20-87 years were enrolled. The long diameter of the orbits, orbital ellipticity, OOM thickness, and OOM attachment to the inferior orbital rim were analyzed. These variables were statistically evaluated for their relationship with age.


RESULTS
The long diameter of the orbit was significantly longer in those over than in those under 60 years, with a moderate and significant positive correlation between orbital ellipticity and age. OOM thickness and age showed a strong negative correlation. The degree of OOM attachment to the inferior orbital rim decreased significantly with age.


CONCLUSIONS
This study showed that age-related changes of the bony orbit in Japanese individuals tended to be the same as those in Caucasians, but there were differences in degree of changes observed. As a new finding in the Japanese population, the OOM not only thins with aging, but also gradually loosens from the facial bone. In the elderly, only the nasal side of the OOM was attached to the bone. In clinical application, this could contribute to the development of cosmetic surgeries.