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This is the long medical term for baggy eyelids. Dermatochalasis occurs most frequently in patients older than 50. Since tissues around the eyes are very loose and movable, this area is the most likely of all in the body for early wrinkles and droops. These become stretched, and this stretching is accompanied by thinning and protrusion of the skin.
The true cause of the elastic degeneration, other than aging, is unknown. It is not a dietary or vitamin deficiency. It is, however, aggravated by exposure to the sun.
The soft loose tissues of the upper lids are most affected by Dermatochalasis. Sometimes this skin actually lies on top of the lashes, so some patients are able to keep their eyes open only by keeping the brow elevated with the muscles of the forehead and scalp. This may cause headaches and excessive fatigue, especially with reading. The upper portion of vision may also be cut off by this excessive tissue.
The lower lids are also affected, but usually to a lesser degree. They do not cause the functional problems, i.e. reading and general vision difficulties, as do the upper lids; however, baggy lower lids present a cosmetic concern for many patients.
Treatment is first directed at prevention, by avoiding the harmful rays of the sun, but Dermatochalasis is probably hereditary, will occur with time, and is part of the normal aging process. The only effective treatment we have to offer is surgery.
This procedure simply involves tightening the loose tissues around the eyes. Excess skin is removed, and sometimes the muscle underlying the skin is also tightened. Occasionally deeper layers of fat are also excised. Scarring after surgery is usually minimal; these tissues are very forgiving and heal well.
A considerable amount of bruising and swelling may accompany the procedure. Ice packs for 24 hours after surgery help some, but some people can expect to look like a “raccoon” for a week or two after surgery. Sunglasses hide this nicely in the first few days after surgery. The skin stitches are removed sometime in the first week, depending on the patient’s healing process.
The risks associated with surgery are small, but real. If too much skin is taken, difficulty closing the eyes may result.
This creates a “dry eye” and is very uncomfortable. Very rarely, loss of vision results from bleeding around the eyes. If pain is noted after the operation, immediate attention is required to prevent any lasting visual problems.