Medial vs Central Upper Eyelid Fat: A Histological and Immunohistochemical Study of Structural and Vascular…

StudyAesthetic surgery journal. Open forum· 2026

Medial vs Central Upper Eyelid Fat: A Histological and Immunohistochemical Study of Structural and Vascular Features.

Lukas Prantl, Hanna Guice, Sophia-Theresa Diesch … Tom Schimanski

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Medial upper eyelid fat has more connective tissue than central fat

Medial vs Central Upper Eyelid Fat: A Histological and Immunohistochemical Study of Structural and Vascular Features.

Lukas Prantl … Tom Schimanski

Aesthetic surgery journal · 2026 · Q1 in General Medicine

Background

The medial upper eyelid fat compartment has long been recognized clinically as being firmer, whiter, and more fibrous than the central preaponeurotic fat.

Purpose

The objective of this study was to quantitatively compare the histological and immunohistochemical characteristics of medial and central upper eyelid fat compartments, with particular focus on connective tissue composition, vascularization, and stromal nuclear density.

Methods

In a paired-sample design, medial and central upper eyelid fat compartments were harvested from 10 patients undergoing upper blepharoplasty.

n = 10 patients

Results

medial eyelid fat has more fibrous, structural tissue than central fat

67.74%

Medial

56.63%

Central

More results

In contrast, capillary density was significantly reduced in the medial compartment (1.60 ± 0.54% vs 3.04 ± 1.14%, P = .002).

Stromal nuclear density was also lower in medial fat compared with central fat (0.85 ± 0.66% vs 1.76 ± 1.06%, P = .004).

More results

Across all parameters, the central compartment consistently showed higher stromal nuclear density and vascularization, whereas the medial fat exhibited increased fibrous density.

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Conclusion · 1 of 2

The medial upper eyelid fat compartment differs histologically from the central compartment by an increased connective tissue content and reduced vascular and stromal cell density.

Conclusion · 2 of 2

These findings provide a structural basis for its clinically observed firmness and potentially altered regenerative behavior.

Medial vs Central Upper Eyelid Fat: A Histological and Immunohistochemical Study of Structural and Vascular Features.

Medial vs Central Upper Eyelid Fat: A Histological and Immunohistochemical Study of Structural and Vascular Features.

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