Drooping upper eyelids, also known as drooping eyelids, age the face and make it look tired and weary. Often, there is also a medical indication when sufferers decide to undergo surgery. Blepharochalasis, the medical term for drooping eyelids, affects both men and women.
What is blepharochalasis?
By drooping eyelids, medicine understands a malposition of the upper eyelid: its upper part is bulging and also hangs laterally beyond the edge of the eyelid. Drooping eyelids occur as acute and recurrent upper eyelid swelling that disappears on its own after a certain time. In patients over midlife, it is permanent. Drooping eyelids are usually bilateral and may be congenital or result from the natural skin aging process. Genetically caused drooping eyelids combined with obesity and goiter are classified under the umbrella term Ascher syndrome. Due to the drooping of the eyelids, the eyes become smaller, and the facial expression also changes. The affected person appears tired, fatigued and older than he actually is. Many patients suffer so much from this that they consider surgical correction of their aesthetic problem. This is especially true when the unsightly drooping eyelids are joined by a lowering of the brows. It is usually also caused by age-related sagging of the connective tissue.
Causes
Due to recurrent painless eye edema and age-related connective tissue weakness, the upper eyelid sags so much that it droops. In some cases, fat prolapse, excess tissue in the eye ring muscle, or paralysis of the fascialis are also culprits in the development of drooping upper eyelids. In fat prolapse, the fatty tissue located in the eyeball pushes forward from the orbit and fills with lymphatic water. In most cases, however, drooping eyelids are a purely cosmetic problem caused by the loss of elasticity of the skin and the slackening of the connective tissue. Drooping eyelids are particularly pronounced when the eyebrows hang down at the same time. Sometimes even brow ptosis is the sole cause of this aesthetic problem. The appearance of drooping eyelids is also promoted by an unhealthy lifestyle: Heavy smoking, high alcohol consumption, lack of sleep and stress cause the skin to age faster.
Symptoms, complaints and signs
Drooping eyelids are a major psychological problem, especially for people who value a young and dynamic appearance. They suffer from the fact that their face looks unattractive to other people. The eyelids are often perceived as heavy and cause headaches. In severe cases, there is even a restriction of the visual field: the direction of vision upwards and/or to the side is impaired. The risk of accidents is greater than in people without drooping eyelids.
Diagnosis and progression
Anyone who has drooping eyelids that they would like to have surgically removed should first have an ophthalmologic examination. The ophthalmologist will determine if the eyelid margin is normally shaped and also if there is no weakness of the eyelid elevator muscles (ptosis). He also finds out whether the patient has a neurological disease (fascialis paralysis). However, if the problem is completely normal drooping eyelids, a measurement of the visual field is performed: the ophthalmologist determines whether and to what extent it is restricted.
Complications
Blepharochalasis does not usually cause complications. This symptom is almost exclusively a cosmetic problem that does not necessarily require treatment. In many cases, however, the patient is not satisfied with his or her appearance. This can lead to depression and lowered self-esteem, which is most common in younger people. The depression often causes stress and headaches. In some cases, the eyelids can also be so heavy that they also lead to headaches. Rarely, defects in the visual field also occur, leading to further complications. Affected individuals usually have a limited field of vision and are therefore at greater risk of accidents. Treatment is possible through cosmetic surgery. In this case, a tightening is performed, which, however, has to be repeated again and again. Complications do not occur. After the surgical procedure, there is swelling and slight pain.These disappear after a few days. A wound does not remain. However, it takes about a month before the patient can see the result of the surgery.
When should you go to the doctor?
It is not necessary to see a doctor in every case of blepharochalasis. In most cases, the visit to the doctor is necessary only when the affected person feels uncomfortable with this complaint or when the patient’s visual field is limited by the disease. In many cases, blepharochalasis can also increase the risk of various accidents, so treatment should be carried out, especially in children or the elderly, to prevent further complications or secondary damage. A doctor must also be consulted if blepharochalasis leads to psychological complaints or depression. It is not uncommon for those affected to suffer from inferiority complexes or reduced self-esteem. In this case, too, a visit to a medical professional is recommended. Further treatment usually depends on the underlying disease and can be performed by an ophthalmologist. In the case of psychological complaints, a psychologist should be consulted so that the symptoms of blepharochalasis can be completely limited.
Treatment and therapy
The patient can have the drooping eyelids surgically removed with an upper eyelid lift (blepharoplasty) or injected with Botox. In addition, he or she can undergo radiage. The most common method is the upper eyelid lift. It is performed on an outpatient basis with a scalpel or laser and is performed by a specialist in aesthetic plastic surgery. Ideally, he has several years of experience in the field of eyelid lifting. The patient can obtain relevant information from the relevant medical association. During upper eyelid lifting, the excess skin and part of the fatty tissue are cut out directly in the fold of the eyelid. Sometimes, part of the eyelid closing muscle is also removed in the process. The suture is placed in the fold, so that the scar is invisible later. On the side, it is hidden anyway by the crow’s feet located there. The 60-minute surgical procedure is performed under local anesthesia. If the operation proceeds normally, the hematomas and swellings that develop in the area of the eyes will be visible for a week at most. If the procedure is performed correctly, postoperative bleeding is rare. Brow sagging can be injected with Botox. However, this cosmetic surgery treatment must be repeated every 3 to 6 months, as the botulinum toxin is broken down by the body in the meantime. In the new type of radiage, the upper eyelid tissue is heated using radio frequency technology so that the collagen stored in the skin contracts and the swelling goes down. Radiage, which is performed on an outpatient basis in 30 to 60 minutes and is also much less expensive, has the advantage that the patient can return to work immediately after the procedure. Depending on the skin condition, several treatments may be necessary. The slight redness in the eye area often disappears within 24 hours. The final result can be seen in a few months at the latest. Radiage should be repeated after one to three years.
Outlook and prognosis
The prognosis of blepharochalasis is favorable. Many people choose not to undergo medical treatment because the procedure is more of a visual improvement than a physical necessity. There are no limitations in the functional abilities of the body with blepharochalasis. Vision remains undiminished despite the drooping eyelid. Nevertheless, emotional and mental stress can occur due to the optical blemish. For this reason, corrective treatment can be performed in a surgical procedure. The operation is a routine one-hour procedure, with a subsequent prospect of healing and freedom from symptoms. Nevertheless, the treatment is associated with the usual risks and side effects of surgery. Complications and problems with wound healing may occur. These prolong the healing process. With a healthy and balanced diet, the affected person can specifically support the healing success. If a patient decides to undergo cosmetic correction by injecting Botox, there is no lasting relief from the symptoms. Within a few months, blepharochalasis gradually returns until they are completely present again after 6 months.A repetition of the treatment is then necessary. The patient can take preventive measures on his own responsibility by using special creams, massages or training the facial muscles. Likewise, he thus supports the healing success after a treatment.
Prevention
In order to prevent the development of drooping eyelids caused by sagging connective tissue, it is recommended to be as healthy as possible. Sufficient sleep, not too much stress, at least a limited consumption of nicotine and alcohol, and sleeping with the upper body elevated can help prevent the cosmetic problem from occurring at all or delay its onset. Treating the eye area with certain eye creams recommended by the cosmetic industry cannot prevent drooping eyelids.
Aftercare
In the case of blepharochalasis, aftercare is usually neither necessary nor possible. The affected person must rely on surgical intervention, which usually proceeds without complications and completely relieves the symptoms of the disease. The life expectancy of the affected person is also not negatively affected or reduced by blepharochalasis. After a surgical procedure, the affected person should rest and take care of his body. Strenuous activities or sporting activities should be avoided. Unnecessary exertion and stressful situations should also be avoided. In general, a healthy lifestyle with a healthy diet and regular exercise also has a very positive effect on the further course of the disease and can accelerate healing. In most cases, the redness of the eye disappears relatively quickly, so that there are no particular aesthetic restrictions. In some cases, however, blepharochalasis can lead to psychological complaints or depressive moods. Talking to friends and acquaintances can help, and contact with other sufferers of the disease can also prove useful. In most cases, however, a new intervention is necessary after three years to completely relieve the symptoms.
What you can do yourself
Blepharochalasis is generally a purely cosmetic problem, but sufferers can do something about it themselves. Drooping eyelids make a person look unrested and exhausted, and in pronounced form can distort the entire facial expression. If the disorder is accompanied by a lowering of the eyebrows, many people feel downright disfigured. The best form of self-help against blepharochalasis are preventive measures that counteract premature aging of the skin. Healthy, low-fat, vitamin– and fiber-rich nutrition, sufficient sleep and regular exercise, preferably in the fresh air, are beneficial. On the other hand, nicotine consumption, excessive alcohol consumption and a nutrient-poor diet, lack of exercise and obesity have a negative effect. If drooping eyelids have already formed, they can be combated in the initial stages with simple home remedies and cosmetics. If you suffer from puffy eyes and drooping eyelids, especially in the morning, you should wrap an ice cube in a paper napkin and place it on your eyes, which has a decongestant effect. Eye rollers and eye creams that have a cooling and decongestant effect are also available in cosmetics stores. The right eye make-up can visually conceal drooping eyelids and make them less noticeable. Those affected can learn appropriate make-up techniques from a trained beautician. In severe cases, especially if those affected also suffer psychologically from their blemish, they should consult a plastic surgeon and consider surgical correction.
