Under Eye Puffiness Surgery for Hyperthyroidism Patients?

Why can't people with hyperthyroidism have surgery for under eye puffiness?

Doctor Answers 4

Eyelid surgery and hyperthyroidism

There are many issues to consider in performing blepharoplasty of the lower lids in a patient with hyperthyroidism. The first concern is to make sure that all of your thyroid issues are addressed prior to any surgery. Once you are medically stable it would be of great benefit to visit with a surgeon who is familiar with hyperthyroidism, exophthalmus, and cosmetic issues related to the lower lids. It may be more than simply fat which is contributing to your lower lid puffiness and there may be problems with the muscles that control the movement of your eye or tissue edema from treatment of your hyperthyroidism that may not respond well to surgery.

Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

Eyelid appearance in Hyperthyroid Patients

Hi there-

I agree with Dr. Aldea- once your thyroid function is controlled at a normal level and your eyelid appearance is stable, it may be possible to offer you some improvement- but until then it's not safe for you.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 159 reviews

Eyelid Surgery in Hyperthyroidism Patients

Hyperthyroidism is a systemic disease in which the metabolism (pulse, blood pressure, temperature) is operating at an exaggerated rate. Operating on such a patient can precipitate a dreaded complication CALLED Thyroid Storm which could be fatal. It is therefore essential to control and slow the thyroid and metabolic rate to normal level before attempting ANY elective operations.

Achieving a normal metabolic rate with a steady state (eu)thyroid is important both metabolically and anatomically. As surgeons, we want to see what a structure looks like normally - not when artificially enlarged by weight gain or, in this case, an over-active thyroid.

In performing eyelid surgery, the position of the globe relative to the edge of the eye socket is critical. Although in many cases a prominent (PROPTOTIC) eye (IE globe lurching too much forward and lower lid having little to no support and being pulled down) is due to a natural deficiency of the cheek bone - in hyperthyroid cases it may not be.

In certain forms of hyperthyroidism the fat under the globe and in the lower lid increases in volume greatly and pushes the globe forward resulting in the classic "staring" hyperthyroid eye appearance.

The reluctance of surgeons to tackle hyperthyroid patients has a lot to do with their wanting to wait until the appearance of the eyes and lids is stable and thyroid gland function has normalized. Only then can permanent decisions on how to ideally handle excess fat, lid laxity globe position etc be addressed safely.

Hope this helps.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Eye surgery for hyperthyroid patients

In South Florida, you might want to be evaluated by Dr. Steven Fagien who is an ophthalmologist who specializes in eyelid surgery. He can evaluate you and tell you if there is anything safe that can be done.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.