The presence of a lateral fat pad beneath the orbicularis muscle, which overlies the lateral orbital rim, is described in patients who have marked bagginess of the upper lid and a bulky hood of tissue extending well beyond the lateral canthal region. This fat is separate from the fusiform central fat pad and lies superficial to the orbital septum. Resection of a strip of orbicularis muscle and the underlying lateral fat pad, in addition to the routine removal of central and medial fat pads, provides an enhanced appearance and complete correction of the lateral hood in such individuals.
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John Q. Owsley (1980) studied this question.