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Eyelid anatomy, illustrated

The layers of the upper and lower eyelid, the fat pads behind them and how the main operations reach them. Each illustration is drawn from public anatomy plates and checked against the anatomy literature; the numbers match the key beside it.

By Medical Advertising Agency, publisher of blepharoplasty.pro · Updated October 17, 2026

The eyelid, layer by layer

Medical illustrations, labelled. The numbers match the key.

Medical illustration of the right eye region of a woman about 55 seen from the front: eyebrow, upper eyelid crease with mild hooding of the outer fold, lid margins and lashes, the inner corner with the caruncle, the slightly higher outer corner, lower lid fullness, tear trough and lid-cheek junction.

Eyelid surface landmarks

The right eye of a woman in her mid-fifties, showing the brow, the upper lid crease and fold, the corners of the eye, the tear trough and the lid-cheek junction.

  1. Eyebrow
  2. Upper eyelid crease
  3. Upper eyelid skin fold
  4. Upper eyelid margin and lashes
  5. Lateral canthus
  6. Medial canthus
  7. Caruncle
  8. Lower eyelid margin
  9. Lower eyelid
  10. Tear trough
  11. Lid-cheek junction
  12. Cheek
  13. Iris
  14. Pupil
  15. Sclera

Anatomy checked against StatPearls. Anatomy, Head and Neck: Eyelid, StatPearls. Blepharoplasty, StatPearls. Blepharoplasty, Lower Lid, Canthal Support, Wong CH et al. The tear trough ligament: anatomical basis for the tear trough deformity. Plast Reconstr Surg 2012, Muzaffar AR et al. Surgical anatomy of the ligamentous attachments of the lower lid and lateral canthus. Plast Reconstr Surg 2002.

Medical illustration of the upper eyelid cut from top to bottom through the pupil, face to the right: skin, orbicularis muscle, orbital septum, preaponeurotic fat, levator muscle and aponeurosis, Müller muscle, tarsus and conjunctiva lying over the eyeball.

Upper eyelid cross-section

Cross-section of the closed upper eyelid through the middle of the pupil, from the brow down to the lashes.

  1. Eyebrow
  2. Orbicularis oculi, orbital part
  3. Brow fat (ROOF)
  4. Frontal bone, superior orbital rim
  5. Orbital septum
  6. Preaponeurotic fat pad
  7. Whitnall ligament
  8. Levator palpebrae superioris muscle
  9. Levator aponeurosis
  10. Müller muscle
  11. Superior rectus muscle
  12. Superior conjunctival fornix
  13. Orbicularis oculi, preseptal part
  14. Peripheral arterial arcade
  15. Eyelid crease
  16. Tarsus with meibomian glands
  17. Orbicularis oculi, pretarsal part
  18. Skin
  19. Eyelashes
  20. Cornea
  21. Iris
  22. Lens

Anatomy checked against StatPearls. Anatomy, Head and Neck: Eyelid, StatPearls. Anatomy, Head and Neck: Eye, Superior Tarsal Muscle (Müller Muscle), Hwang K. Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol 2013, Meyer DR et al. Anatomy of the orbital septum and associated eyelid connective tissues. Ophthalmic Plast Reconstr Surg 1991, Anderson RL, Beard C. The levator aponeurosis. Attachments and their clinical significance. Arch Ophthalmol 1977, Kakizaki H et al. Whitnall ligament anatomy revisited. Clin Exp Ophthalmol 2011, May JW Jr et al. Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty. Plast Reconstr Surg 1990, EyeWiki. Aponeurotic Blepharoptosis, Gray's Anatomy (1918), fig. 893: sagittal section of the upper eyelid.

Medical illustration of the lower eyelid cut from top to bottom through the pupil, face to the right: skin, orbicularis muscle, the short lower tarsus, orbital septum, central fat pad, capsulopalpebral fascia, inferior oblique and inferior rectus muscles, conjunctival fornix, orbital rim, orbicularis retaining ligament and cheek fat.

Lower eyelid cross-section

Cross-section of the closed lower eyelid through the middle of the pupil, from the lashes down to the cheek.

  1. Skin
  2. Orbicularis oculi, pretarsal part
  3. Tarsus with meibomian glands
  4. Eyelashes
  5. Orbicularis oculi, preseptal part
  6. Capsulopalpebral fascia (lower lid retractor)
  7. Orbital septum
  8. Central fat pad
  9. Conjunctiva
  10. Inferior conjunctival fornix
  11. Inferior oblique muscle
  12. Inferior rectus muscle
  13. Orbital fat
  14. Orbital floor (maxilla)
  15. Maxillary sinus
  16. Inferior orbital rim
  17. Orbicularis retaining ligament
  18. Lid-cheek junction
  19. Suborbicularis oculi fat (SOOF)
  20. Orbicularis oculi, orbital part
  21. Subcutaneous fat
  22. Cornea
  23. Iris
  24. Lens
  25. Upper eyelid

Anatomy checked against StatPearls. Anatomy, Head and Neck: Eyelid, Hwang K. Surgical anatomy of the lower eyelid relating to lower blepharoplasty. Anat Cell Biol 2010, Hawes MJ, Dortzbach RK. The microscopic anatomy of the lower eyelid retractors. Arch Ophthalmol 1982, Kakizaki H et al. Lower eyelid anatomy: an update. Ann Plast Surg 2009, Kawakita T et al. Measurement of fornix depth and area. Eye 2009, Muzaffar AR et al. Surgical anatomy of the ligamentous attachments of the lower lid and lateral canthus. Plast Reconstr Surg 2002, Aiache AE, Ramirez OH. The suborbicularis oculi fat pads: an anatomic and clinical study. Plast Reconstr Surg 1995, Gray's Anatomy (1918), fig. 891: sagittal section of the orbit.

Medical illustration of the right eye region from the front with skin and muscle removed: the lacrimal gland, the central and nasal fat pads of the upper eyelid, the lateral, central and medial fat pads of the lower eyelid with the inferior oblique muscle between the medial and central pads, the tarsal plates and canthal tendons, framed by the bony orbital rim.

Orbital fat pads, front view

The right eye from the front with the skin and orbicularis removed and the orbital septum opened, showing the fat pads of the upper and lower eyelids.

  1. Lacrimal gland
  2. Central fat pad, upper eyelid
  3. Nasal fat pad, upper eyelid
  4. Levator aponeurosis
  5. Upper tarsus with meibomian glands
  6. Lateral canthal tendon
  7. Medial canthal tendon
  8. Caruncle
  9. Lower tarsus
  10. Lateral fat pad, lower eyelid
  11. Central fat pad, lower eyelid
  12. Medial fat pad, lower eyelid
  13. Inferior oblique muscle
  14. Arcuate expansion
  15. Cut edge of the orbital septum
  16. Supraorbital notch
  17. Infraorbital foramen
  18. Lateral orbital rim
  19. Iris
  20. Sclera

Anatomy checked against StatPearls. Anatomy, Head and Neck: Eyelid, StatPearls. Blepharoplasty, StatPearls. Transconjunctival Blepharoplasty, Hwang K. Surgical anatomy of the lower eyelid relating to lower blepharoplasty. Anat Cell Biol 2010, Massry GG. Prevalence of lacrimal gland prolapse in the functional blepharoplasty population. Ophthalmic Plast Reconstr Surg 2011, Gray's Anatomy (1918), fig. 894: tarsi and their ligaments.

How the operations are done

Medical illustrations, labelled. The numbers match the key.

Two-panel medical illustration of the right eye from the front. Left: eye closed, a crescent of skin and a strip of orbicularis muscle removed between violet marking lines in the upper lid crease, exposing the orbital septum and the pale nasal fat pad. Right: eye open after surgery, with a fine sutured incision in the crease that ends a little beyond the outer corner of the eye.

Upper blepharoplasty

Upper eyelid skin is removed through an incision in the natural crease (left), and the wound is closed so the scar lies in the crease (right).

  1. Lower incision line in the eyelid crease
  2. Upper incision line
  3. Orbital septum
  4. Central fat pad behind the septum
  5. Nasal fat pad
  6. Orbicularis oculi, cut edge
  7. Lateral end of the incision
  8. Closed incision in the eyelid crease
  9. Lateral end of the closed incision

Anatomy checked against StatPearls. Blepharoplasty, StatPearls. Anatomy, Head and Neck: Eyelid, Hwang K. Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol 2013.

Two side-section medical illustrations of the lower eyelid, face to the right. Left: the conjunctiva and lower lid retractors are opened on the inner surface of the lid and the central fat pad bulges through, with the skin, orbicularis and septum untouched. Right: a skin incision just below the lashes, a strip of pretarsal orbicularis kept, the skin and muscle lifted as one flap off the septum down to the rim, and the septum opened over the fat. Dashed arrows show each route.

Lower blepharoplasty approaches

The lower eyelid fat is reached either through the inside of the lid (left, transconjunctival) or through a skin incision just below the lashes (right, subciliary).

  1. Transconjunctival incision
  2. Central fat pad
  3. Orbital septum, not opened
  4. Skin and orbicularis, not cut
  5. Lower tarsus
  6. Inferior oblique muscle
  7. Subciliary skin incision
  8. Pretarsal orbicularis, preserved
  9. Skin-muscle flap
  10. Plane in front of the septum
  11. Orbital septum, opened
  12. Central fat pad

Anatomy checked against StatPearls. Transconjunctival Blepharoplasty, StatPearls. Blepharoplasty Subciliary Approach, StatPearls. Anatomy, Head and Neck: Eyelid, Hwang K. Surgical anatomy of the lower eyelid relating to lower blepharoplasty. Anat Cell Biol 2010.

Medical illustration of the lower eyelid cut from top to bottom through the pupil, face to the right, after fat repositioning: a small incision in the conjunctiva inside the lid, the central fat pad continuing as one tongue of fat over the inferior orbital rim onto the front of the maxilla under the orbicularis muscle, and the orbital septum ending free in front of the fat. A dashed arrow shows the path of the fat.

Fat repositioning

Cross-section of the lower eyelid after fat repositioning: through an incision inside the lid, the orbital septum is released from the bony rim and a tongue of eyelid fat, still attached at its base, is moved over the rim onto the cheekbone.

  1. Transconjunctival incision
  2. Central fat pad
  3. Fat moved over the orbital rim
  4. Orbital septum, released from the rim
  5. Inferior orbital rim
  6. Maxilla
  7. Orbicularis oculi muscle
  8. Orbicularis retaining ligament
  9. Skin
  10. Lower tarsus
  11. Inferior oblique muscle
  12. Conjunctiva
  13. Maxillary sinus

Anatomy checked against Hamra ST. Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 1995, Goldberg RA. Transconjunctival orbital fat repositioning: transposition of orbital fat pedicles into a subperiosteal pocket. Plast Reconstr Surg 2000, StatPearls. Transconjunctival Blepharoplasty, Hwang K. Surgical anatomy of the lower eyelid relating to lower blepharoplasty. Anat Cell Biol 2010, Muzaffar AR et al. Surgical anatomy of the ligamentous attachments of the lower lid and lateral canthus. Plast Reconstr Surg 2002.

Two-panel medical illustration. Left: side cross-section of the upper eyelid, face to the right, during external levator advancement: the skin and orbicularis are opened at the crease, the orbital septum is opened and the preaponeurotic fat is lifted, and a blue suture passes through the levator aponeurosis and the front part of the tarsus. Right: front view of a right eye with the upper eyelid turned inside out over a Desmarres retractor and a Putterman clamp holding a fold of Müller muscle and conjunctiva just beyond the upper border of the tarsus.

Ptosis repair

Two ways to raise a drooping upper eyelid: through a crease incision the levator aponeurosis is stitched to the front of the tarsus (left), or from inside the turned-out eyelid a strip of Müller muscle and conjunctiva is clamped for removal (right).

  1. Levator palpebrae superioris muscle
  2. Levator aponeurosis
  3. Müller muscle
  4. Preaponeurotic fat, lifted
  5. Orbital septum, opened
  6. Crease incision
  7. Orbicularis oculi muscle
  8. Tarsus
  9. Suture through the aponeurosis and the front of the tarsus
  10. Desmarres retractor
  11. Eyelashes of the everted eyelid
  12. Tarsus, inner surface
  13. Upper border of the tarsus
  14. Putterman clamp
  15. Müller muscle and conjunctiva in the clamp

Anatomy checked against EyeWiki. Aponeurotic Blepharoptosis, Anderson RL, Beard C. The levator aponeurosis. Attachments and their clinical significance. Arch Ophthalmol 1977, EyeWiki. Müller's Muscle-Conjunctival Resection (MMCR) Blepharoptosis Repair, Putterman AM, Urist MJ. Müller muscle-conjunctiva resection. Arch Ophthalmol 1975, StatPearls. Anatomy, Head and Neck: Eye, Superior Tarsal Muscle (Müller Muscle), StatPearls. Anatomy, Head and Neck: Eyelid, Hwang K. Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol 2013.

Two side cross-sections of an East Asian upper eyelid, face to the right. In both, the preaponeurotic fat comes down in front of the upper part of the tarsus and the orbital septum joins the levator aponeurosis on the tarsus. Left: a wedge-shaped incision at the planned crease about 7 mm above the lashes reaches the aponeurosis on the tarsus, and a blue stitch passes from the lower skin edge through the aponeurosis to the upper skin edge. Right: a blue stitch loops from a knot buried under the skin at the crease line to the front of the tarsus.

Double eyelid surgery

Cross-sections of an East Asian upper eyelid, where the septum and fat reach down in front of the tarsus. Left: incisional method, with a strip of tissue removed at the planned crease and a stitch joining the skin edges to the levator aponeurosis. Right: buried-suture method, with a stitch from under the skin to the tarsus and no incision.

  1. Levator aponeurosis
  2. Müller muscle
  3. Preaponeurotic fat
  4. Orbital septum
  5. Orbicularis oculi muscle
  6. Tarsus
  7. Incision at the planned crease
  8. Suture from the skin edges to the levator aponeurosis
  9. Buried suture, knot under the skin
  10. Fat in front of the upper tarsus
  11. Septum joining the aponeurosis on the tarsus

Anatomy checked against EyeWiki. Asian Blepharoplasty (Double Eyelid Procedure), Jeong S et al. The Asian upper eyelid: an anatomical study with comparison to the Caucasian eyelid. Arch Ophthalmol 1999, StatPearls. Anatomy, Head and Neck: Eyelid, Hwang K. Surgical anatomy of the upper eyelid relating to upper blepharoplasty or blepharoptosis surgery. Anat Cell Biol 2013.

Two-panel medical illustration of the outer corner of a right eye from the front, with the skin and orbicularis muscle opened beside the eye to show the lateral orbital rim, the lacrimal gland and the lateral fat pad. Left: a blue stitch passes through the white lateral canthal tendon and is tied to the periosteum on the inner surface of the rim. Right: after a cut at the outer corner, a strip of lower eyelid tarsus runs to the inner surface of the rim, where a blue stitch fixes it, with a dashed line marking the excess to be trimmed; the upper part of the canthal tendon is intact.

Canthopexy and canthoplasty

Two ways to tighten the outer corner of the eye. Left, canthopexy: the lateral canthal tendon stays attached and is stitched to the periosteum on the inner side of the bony orbital rim. Right, canthoplasty with a lateral tarsal strip: the corner is divided, the outer end of the lower eyelid tarsus is cut into a strip, shortened and stitched to the same spot inside the rim.

  1. Lateral orbital rim
  2. Inner surface of the orbital rim
  3. Lateral canthal tendon
  4. Suture from the tendon to the periosteum inside the rim
  5. Lacrimal gland
  6. Lateral fat pad, lower eyelid
  7. Orbicularis oculi, cut edge
  8. Lateral canthus
  9. Tarsal strip from the lower eyelid
  10. Upper limb of the lateral canthal tendon
  11. Trim line on the excess strip
  12. Suture from the strip to the periosteum inside the rim
  13. Canthotomy

Anatomy checked against StatPearls. Blepharoplasty, Lower Lid, Canthal Support, Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol 1979, Muzaffar AR et al. Surgical anatomy of the ligamentous attachments of the lower lid and lateral canthus. Plast Reconstr Surg 2002, StatPearls. Anatomy, Head and Neck: Eyelid.

Three front views of the same woman about 55 with her hair pulled back. Left: violet marks for an endoscopic brow lift, one median and two paramedian incisions just behind the frontal hairline and one incision behind each temporal hairline on a dashed line drawn from the side of the nose through the outer corner of the eye. Middle: one violet incision in the hair of each temple for a temporal brow lift. Right: a shaded violet ellipse just above each eyebrow marking the skin removed in a direct brow lift.

Brow lift incisions

Incision sites for three brow lifts. Left, endoscopic: three short cuts behind the frontal hairline and one behind each temporal hairline. Middle, temporal: one short cut in the hair of each temple. Right, direct: an ellipse of skin removed just above each eyebrow.

  1. Median incision
  2. Paramedian incision
  3. Frontal hairline
  4. Temporal incision
  5. Line from the nasal ala through the lateral canthus
  6. Temporal brow lift incision
  7. Temporal hairline
  8. Skin removed above the eyebrow
  9. Eyebrow

Anatomy checked against StatPearls. Endoscopic Brow Lift, Turin SY et al. Simplified Lateral Brow Lift under Local Anesthesia. Plast Reconstr Surg Glob Open 2019; Foustanos A. Lateral Brow Lift. Arch Plast Surg 2015, Perry JD, Hwang CJ. Direct Browlift. Clin Plast Surg 2022.

The operations

Each page covers what the operation treats, how it is done, the risks and the recovery, with the surgeons who show this work.

Upper blepharoplastyLower blepharoplastyHooded eyelidsDroopy eyelidsTear trough and lid-cheek junction surgeryEye bags and lower eyelid bagsBlepharoplasty by agePtosis surgery (blepharoptosis repair)Upper blepharoplasty with ptosis repairHollow upper eyelid and fat graftingTransconjunctival blepharoplastyFat repositioning in lower blepharoplastyFestoons and malar bagsLower eyelid retraction, ectropion and entropionBlepharoplasty scarsFunctional blepharoplasty and visual fieldsBlepharoplasty complicationsUnder-eye filler versus lower blepharoplastyUpneeq and nonsurgical ptosis treatmentDouble eyelid surgeryDouble eyelid revision surgeryCanthoplasty and canthopexyFox eye and canthal tilt surgeryRevision blepharoplastyEndoscopic brow liftTemporal and lateral brow liftBrowpexy and direct brow liftBlepharoplasty with facelift and brow lift