How Can Upper Blephoroplasty Address Dynamic Upper Lids and Impact Edema? (photo)

I was told by doctors that I could benefit from upper eye lid surgery. The issue is, my eyes look different every day; even the folds of skin seem to take on different formations. Sometimes lids concealed by lax skin and other times not. How can bleph produce consistent results if eyes so dynamic? Also, I am predisposed to (occasionally extreme) edema! Allergies have been ruled out! Would an upper lid bleph aggravate my edema? How would dr. perform bleph if edema is present on day of surgery?

Doctor Answers 7


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Blepharochalasis, which is what you are showing in your photos, is a condition, usually idiopathic [unknown reason] that causes repeated swelling of the eyelid tissues. This is one of the most frustrating conditions that Oculoplastics surgeons encounter. Repeated bouts of this can lead excess, crepy skin that may benefit from surgery [blepharoplasty] or laser resurfacing.

There are some underlying medical conditions that need to be ruled out first. Thyroid eye disease is not an uncommon condition that may present this way, on occasion. Kidney disease or heart disease may also cause problems with your bodies fluid retention. There are some medications that can also cause this type of problem. Another rare condition that causes this type of picture is hereditary angioedema caused by a plasma protein C1 inhibitor (C1-INH) deficiency, and there is a blood test to check for this.

I would see your primary care provider so he/she can rule out the medical conditions, and if you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.


Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Eyelid edema

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If you are having such a ttremendous amount of lid edema I think it would be prudent and wise to find out why this is happening before you get surgery on your eyelids.It may be some allergic reaction.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

How Can Upper Blephoroplasty Address Dynamic Upper Lids and Impact Edema?

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 These are huge swings in eyelid swelling and excess skin and while these drastic swings are happening, you are not a good candidate for eyelid surgery IMHO.  You should instead investigate the cause of this marked, intermittent edema.  I also suspect your eyebrows are low and should be evaluated for a possible Brow Lift as well.  I'd start with your internist to find edema cause first.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

See an oculoplastic surgeon

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It's essential that you see more than a few oculoplastic surgeons before doing anything.  Could a blepharoplasty help you with this condition?  Perhaps, but this is one where physical exam, thorough workup, and history are an absolute requirement.  


Oculoplastic, oculoplastic, oculoplastic surgeon and even then proceed with some caution.


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

How Can Upper Blephoroplasty Address Dynamic Upper Lids and Impact Edema?

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Thanks for the series of posted photos. First I would try to treat the unregulated eyelid edema before having an upper lid blepharoplasty. If after the operation you still are having edema issues than the excision of skin will not correct those issues. If you are swollen on the day of surgery I would cancel the operation. 

Impact edema and upper lid blepharoplasty

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I do not think you are using the term impact edema accurately because there is no impact in your case. If allergies have been ruled out, I would recommend that you rule out labile hypertension and water retention which might be alleviated by medication and reduction of sodium in your diet.

Blepharoplasty in ever-changing eyelids

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Based on your pictures, what you are calling dynamic may be a condition called blepharochalasis.  This is something that would have to be diagnosed after a complete exam, but is an uncommon, waxing and waning swelling of the upper and sometimes lower eyelids. It usually affects younger people and can eventually lead to stretching out of the eyelid skin.  Before having any surgery, see an oculoplastic specialist who is trained to know the difference between just baggy eyelid skin caused by genetics and blepharochalasis.  Surgery would not eliminate the swelling in blepharochalasis and you may have a less than ideal outcome. 

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 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.