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Aesthetics (lift) of the ocular complex
Medical expert of the article
Last reviewed: 08.07.2025
The surgeon must evaluate the orbital complex in relation to all structures of the upper face. Attention must be paid to the position of the eyebrows, the wrinkling of the glabella, the degree of displacement of the periorbital fat and periorbital structures such as the eyebrows, fat, lateral angles of the eyes, fat under the orbicularis oculi, and the zygomatic eminence.
The "classic" eyebrow medially originates from a vertical line drawn through the junction of the ala of the nose with the facial tissues. Laterally, it extends along a line drawn from the above-mentioned point through the lateral canthus. Laterally and medially, the eyebrow should be at the same horizontal level. Typically, in women, the eyebrow arches slightly above the rim of the orbit, while in men it is more horizontal. The male eyebrow should be located at the upper edge of the orbit, while the female eyebrow is significantly higher, and its highest point should not be at the lateral edge of the cornea, as is often described, but at the level of the lateral canthus.
A more medial elevation creates an unnatural, surprised appearance. The glabella should be free of folds at rest. The infraorbital fat should be positioned slightly lateral to the plane tangent to the orbital rim. The inferior and lateral orbital rims should be supported by malar and suborbicularis oculi fat. When the midface structures are ptotic and the orbital rim is visible, the orbital fat protruding above it and the suborbicularis oculi fat protruding below it create a double contour. Attempts to correct this with lower blepharoplasty and excess fat removal result in a sunken, sunken appearance in the area. Other treatments, including infraorbital implants and orbital fat redistribution, camouflage the double contour; however, unlike a midface lift, they cannot return the suborbicularis oculi fat to its earlier, more youthful-appearing position.
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