Blepharochalasis – Causes, Symptoms & Treatment


Drooping upper eyelids, also known as drooping eyelids , make the face look older and make it look tired and worn. There is often a medical indication when those affected decide to undergo surgery. Blepharochalasis , the medical term for drooping eyelids , affects men and women equally.

What is blepharochalasis?

Drooping eyelids are medically understood to be a misalignment of the upper eyelid: its upper part is bulging and also hangs laterally over the edge of the eyelid. Drooping eyelids occur as acute and recurring swelling of the upper eyelid, which disappears on its own after a certain period of time. In patients from midlife it is permanent. Drooping eyelids are usually bilateral and can be congenital or caused by the natural skin aging process.

Genetic drooping eyelids combined with obesity and goiter are classified under the umbrella term Ascher syndrome. Lowering the eyelids makes the eyes smaller, and the facial expression also changes. The person concerned appears tired, worn out and older than he actually is. Many patients suffer so much that they consider surgical correction of their aesthetic problem.

This is especially true when the unsightly droopy eyelids are accompanied by a lowering of the brows. It is usually also caused by age-related slackening of the connective tissue .


Due to recurring pain-free eye edema and age-related weakness of the connective tissue, the upper eyelid sags so much that it hangs down. In some cases, fat prolapse, excess tissue in the orbicular muscle or paralysis of the fascialis are also to blame for the development of drooping upper eyelids. In the case of fat prolapse, the fatty tissue in the eyeball pushes forward out of the orbit and fills with lymphatic fluid.

In most cases, however, droopy 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 also hang down. Sometimes even the brow ptosis is the sole cause of the aesthetic problem. The occurrence of droopy eyelids is also favored by an unhealthy lifestyle: Heavy smoking, high alcohol consumption, lack of sleep and stress causes the skin to age faster.

Symptoms, Ailments & 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 appears unattractive to other people. The eyelids are often felt to be heavy and cause headaches. In severe cases, the field of vision is even restricted : the direction of vision upwards and/or to the side is impaired. The risk of accidents is greater than for people without drooping eyelids.

Diagnosis & History

If you have drooping eyelids that you would like to have surgically removed, you should first have an ophthalmological examination. The ophthalmologist determines whether the edge of the eyelid has a normal shape and whether there is any weakness in the levator muscles (ptosis). He also finds out whether the patient has a neurological disease (fascialis paralysis). However, if the drooping eyelids are completely normal, the visual field is measured: the ophthalmologist determines whether and to what extent it is restricted.


There are usually no complications associated with blepharochalasis. This symptom is almost exclusively a cosmetic problem that does not necessarily have to be treated. In many cases, however, the patient is not satisfied with his appearance. This can lead to depression and low self-esteem, which tends to affect younger people.

Depression often leads to stress and headaches. In some cases, the eyelids can also be so heavy that they lead to headaches as well. Defects in the visual field, which lead to further complications, only rarely occur. Those affected usually have a limited field of vision and are therefore exposed to a higher risk of accidents.

It can be treated with cosmetic surgery. A tightening is carried out, which, however, must be repeated again and again. Complications do not arise. After the operation, there is swelling and slight pain. These will 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 operation.

When should you go to the doctor?

In the case of blepharochalasis, a doctor does not always have to be consulted. In most cases, a visit to the doctor is only necessary if the person concerned feels unwell with this complaint or if the patient’s field of vision is restricted by the disease. In many cases, the risk of various accidents due to blepharochalasis can also increase, so that treatment should be carried out, especially in children or elderly people, so that there are no further complications or consequential damage.

A doctor must also be consulted if blepharochalasis leads to psychological problems or depression. It is not uncommon for those affected to suffer from an inferiority complex or reduced self-esteem. Here, too, a visit to a doctor is recommended.

Further treatment usually depends on the underlying disease and can be carried out by an ophthalmologist . In the case of psychological complaints, a psychologist should be consulted so that the symptoms of blepharochalasis can be completely restricted.

Treatment & Therapy

The patient can surgically remove the droopy eyelids with an upper eyelid lift (blepharoplasty) or have Botox injected. He can also undergo a 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 tightening. The patient can request the relevant information from the responsible medical association. In the upper eyelid lift, the excess skin and part of the fatty tissue are cut out directly in the eyelid crease. Sometimes part of the eyelid closure muscle is also removed. The suture is placed in the envelope fold so that the scar is later invisible. On the side it is anyway covered by the crow’s feet located there .

The 60-minute surgical procedure is performed under local anesthesia. If the operation proceeds normally, the bruises and swellings that appear in the eye area are visible for a week at most. If the procedure is performed correctly, postoperative bleeding is rare. Brow depressions can be injected with Botox. However, this cosmetic surgery treatment must be repeated every 3 to 6 months, since the botulinum toxin is broken down by the body in the meantime.

With the innovative 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 carried out on an outpatient basis in 30 to 60 minutes and is also significantly cheaper, has the advantage that the patient can go back to work immediately after the procedure.

Depending on the condition of the skin, 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. The radiation should be repeated after one to three years.

Outlook & Forecast

The prognosis of blepharochalasis is favorable. Many people choose not to seek medical treatment because the procedure is more of an optical 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 visual flaw.

For this reason, a corrective treatment can be carried out in an operative intervention. The operation is a one-hour routine 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 can 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 have a cosmetic correction by injecting Botox, there is no permanent relief of the symptoms. Within a few months, blepharochalasis gradually returns until they are fully present again at 6 months. A repeat of the treatment is then necessary.

With special creams, massages or training of the facial muscles, the patient can take preventive measures on his own responsibility. It also supports the healing success after a treatment.


In order to prevent the development of drooping eyelids caused by loosening of the connective tissue, it is advisable to live as healthy as possible. Adequate sleep, not too much stress, at least limited consumption of nicotine and alcohol, and sleeping with your upper body elevated can help prevent the cosmetic problem from occurring at all or only after a delay. Treating the eye area with certain eye creams recommended by the cosmetics industry cannot prevent drooping eyelids.


In the case of blepharochalasis, follow-up care is usually not necessary and also not possible. The affected person is dependent on a surgical procedure, which usually proceeds without complications and completely alleviates the symptoms of the disease. The life expectancy of those affected is not negatively affected or reduced by blepharochalasis.

After an operation, the person affected should rest and protect their body. Strenuous activities or sporting activities should be avoided. Unnecessary efforts 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 reddening of the eye also disappears relatively quickly, so that there are no particular aesthetic restrictions. In some cases, however, blepharochalasis can lead to psychological problems or depressive moods. Talking to friends and acquaintances can help, and contact with other people affected by the disease can also prove useful. In most cases, however, a repeat operation is necessary after three years in order to completely alleviate the symptoms.

You can do that yourself

Blepharochalasis is usually a purely cosmetic problem, but those affected can also do something about it themselves. Drooping eyelids make a person appear tired and exhausted and can distort the entire facial expression in a pronounced form. 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 skin aging. A healthy, low-fat diet rich in vitamins and fiber , 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 droopy eyelids have already formed, they can still be combated in the early stages with simple home remedies and cosmetics. Anyone who suffers from swollen eyes and droopy eyelids, especially in the morning, should wrap an ice cube in a paper serviette and place it on the eyes, which has a decongesting effect. Eye rollers and eye creams that have a cooling and decongestant effect are also available in cosmetics shops.

The right eye make-up can hide the drooping eyelids and make them less noticeable. Those affected can learn the appropriate make-up techniques from a trained beautician.

In severe cases, especially if those affected are also suffering psychologically from their blemish, they should consult a plastic surgeon and consider surgical correction .

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.