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Development of Graves Orbitopathy After Blepharoplasty:  A Rare Complication

Eben L. Rosenthal, MD; Shan R. Baker, MD
Arch Facial Plast Surg. 1999;1(2):127-129. doi:10.1001/archfaci.1.2.127.
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AESTHETIC blepharoplasty is a commonly performed elective surgical procedure. Facial plastic surgeons are cognizant of the need to identify preexisting thyroid ophthalmopathies during the initial patient interview. We report a case of postoperative Graves orbitopathy (GO) after 4-quadrant blepharoplasty in a patient without a prior history of ophthalmic or thyroid disease.

Complications associated with blepharoplasty are rare and usually limited to lid retraction and lagophthalmos. To our knowledge, activation of previously undiagnosed GO after blepharoplasty has not been previously reported in the literature. The prevalence of GO, although uncertain, has been estimated in studies in the United States at 0.4%. The mean age of presentation for Graves thyroid disease is 41 years and is between 4 and 7 times more common in women. More than 30% of patients diagnosed as having Graves disease will develop orbitopathy. We describe a patient who developed orbitopathy after 4-quadrant blepharoplasty.

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Figure 1.

Preoperative view.

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Figure 3.

Four-month postoperative view: after completion of steroid therapy.

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Figure 2.

One-month postoperative view: note marked swelling and erythema of the right upper and lower eyelids.

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