Periorbital aging and ethnic considerations: a focus on the lateral canthal complex.

Background: There is a general perception that skin from various ethnic groups possesses different properties that may affect barrier function, responsiveness to topical agents, sebum production, chemical sensitivities, and aging changes. The first noticeable signs of facial aging are frequently localized to the upper face, brow, and eyes. The authors postulate that a greater relative descent of the lateral canthal complex in African Americans contributes to periorbital aging more so than in Caucasians.

Methods: The photographic archives of the senior plastic surgeon (J.W.F.) were reviewed. Two hundred ninety-six cases met inclusion criteria. Lateral canthal angles were measured, and the angle assigned to each patient was an average of the right and left lateral canthal angles.

Results: Statistically significant intrarace differences were found for the lateral canthal angle. The median lateral canthal angle for African American patients decreased from 3.00 degrees for those aged 45 years or younger to 1.15 degrees for African American patients older than 45 years (p = 0.03). The median lateral canthal angle for Caucasian patients decreased from 2.30 degrees for those aged 45 years or younger to 1.30 degrees for Caucasian patients older than 45 years (p = 0.00). When the data were age-matched, with 25 subjects in each group, the differences increased.

Conclusions: In comparing young and aged cohorts, African American women demonstrate a more dramatic attenuation of the lateral canthal complex than their Caucasian counterparts. It appears that the lateral canthal complex has been underappreciated, and it is a vital component to periorbital rejuvenation.