What is the term for fatty/sagging eyelids that blepharoplasty corrects?

Dermatochalasis: The Condition Corrected by Blepharoplasty

Blepharoplasty is specifically designed to correct dermatochalasis, which is characterized by excess, redundant skin and fat of the eyelids that causes sagging or hooding of the upper eyelids. 1

Clinical Features of Dermatochalasis

Dermatochalasis presents with several characteristic findings:

• Redundant eyelid tissue overhanging the upper eyelid margin
• Excess skin pushing down on eyelashes
• Laxity of lid structures (skin, orbicularis oculi muscle, and orbital septum)
• May cause functional visual field restriction when severe
• Often associated with aging process of the eyelids 2

Diagnostic Criteria

The diagnosis of dermatochalasis requiring surgical intervention is established when:

• Clinical examination shows excess skin and/or fat of the upper eyelids
• Photographs demonstrate redundant tissue overhanging the upper eyelid margin
• Visual field testing shows improvement of at least 12 degrees in the superior visual field after taping the excess skin 1

Distinguishing Features from Other Eyelid Conditions

Dermatochalasis should be differentiated from:

1. Ptosis - drooping of the upper eyelid due to weakness of the levator muscle or its aponeurosis
2. Blepharochalasis - recurrent episodes of eyelid edema in young patients leading to stretched, thin skin with fine wrinkles, atrophy, and telangiectasias 3
3. Sagging eye syndrome - age-related weakening of supportive bands between the superior and lateral rectus muscles, often presenting with blepharoptosis and deep superior lid sulci 4

Surgical Approach for Dermatochalasis

When performing blepharoplasty for dermatochalasis, the procedure typically involves:

• Removal of excess skin from the upper eyelids
• Excision or repositioning of protruding orbital fat
• Possible tightening of the orbital septum 5
• In cases with concurrent ptosis, repair of the levator aponeurosis may be necessary 1

Potential Complications

Patients should be aware of potential complications including:

• New-onset diplopia (possibly associated with trochlear damage)
• Scarring and hemorrhage in adjacent tissue
• Fat adherence to surrounding structures 1
• Temporary dry eye symptoms
• Asymmetry between eyelids

Recent Advances

For patients seeking less invasive options, newer techniques include:

• Ablative radiofrequency microplasma technology for mild to moderate dermatochalasis 2
• Combined approaches such as blepharoplasty with brow fat pad transfer for simultaneous correction of dermatochalasis and sunken upper eyelids 6

Dermatochalasis is a common condition that increases with age and can significantly impact both appearance and visual function. Blepharoplasty remains the definitive treatment for this condition when properly diagnosed.