# Characteristics and Age-Related Changes in Orbital Fat Protrusion in East Asians: A Retrospective 3-Dimensional Computed Tomography–Based Study

**Authors:** Kiyoko Kato, Itsuko Okuda

PMC · DOI: 10.1093/asjof/ojaf122 · Aesthetic Surgery Journal. Open Forum · 2025-09-26

## TL;DR

This study examines how orbital fat protrusion changes with age in East Asians using 3D CT scans and compares it to Caucasians.

## Contribution

The study provides new insights into age-related changes in orbital fat protrusion specific to East Asians using 3D computed tomography.

## Key findings

- Orbital fat protrusion is present in young East Asians and increases with age.
- East Asians show inherent structural factors contributing to eye bags, unlike Caucasians where aging causes more retrusion.
- Cheek projection increases with age in East Asians, while orbital rim position remains stable.

## Abstract

East Asians have a high prevalence of orbital fat protrusion (eye bags) from a young age, but underlying changes over time have not been extensively assessed.

The aim of the authors of this study is to evaluate age-related changes in orbital fat protrusion and the positional relationship between the eye globe and cheek in East Asians.

This was a retrospective analysis of adults undergoing head and neck computed tomography at a single center. Various parameters were assessed relative to a pupil-centered reference line, including the most anterior points of: the globe (A); inferior orbital fat pad (F); infraorbital rim (O); and cheek (C). Distances AF, AO, AC, and FO (eye bag prominence) were calculated. The East Asian group was also compared with historical Caucasian data through 1:1 matching.

The East Asian population included 224 participants (age range, 20-79 years). Orbital fat (AF) protruded among young individuals, increasing with age; inferior orbital rim position (AO) remained unchanged over time; the cheek (AC) showed a high prevalence of negative vectors from youth, and increased projection with advancing age; eye bags (FO) were present even in young individuals and became somewhat more pronounced with aging. By comparison, the matched Caucasian cohort (n = 22) showed significant decreases in AO and AC and increases in FO with age.

From a young age, East Asians exhibit a high prevalence of orbital fat protrusion. This is largely attributable to inherent structural factors, whereas such protrusion in Caucasians may be primarily because of age-related retrusion of the orbital rim and cheek.

4 (Diagnostic)

## Full-text entities

- **Diseases:** AO (MESH:C535396), AC (MESH:C536084), deformities (MESH:D009140), facial fractures (MESH:D005153), sinusitis (MESH:D012852), atrophy (MESH:D001284), osteoporosis (MESH:D010024)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12596715/full.md

## References

21 references — full list in the complete paper: https://tomesphere.com/paper/PMC12596715/full.md

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Source: https://tomesphere.com/paper/PMC12596715