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Surgical Correction for Pediatric Epiblepharon and Trichiasis

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Published on: July 8, 2025

Stepwise surgery with variable adjustments for severe blepharochalasis with multiple chemical sensitivity: a case

Hisato Nagano¹, Takashi Domoto¹, Ryuichi Azuma¹

¹Department of Plastic and Reconstructive Surgery, National Defense Medical College Hospital, Tokorozawa, Japan.

Case Reports in Plastic Surgery & Hand Surgery

|March 5, 2020

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Blepharochalasis patients with multiple chemical sensitivity (MCS) may experience recurrent eyelid ptosis after standard surgery. A stepwise surgical approach can effectively restore eyelid function and appearance in these complex cases.

Area of Science:

Ophthalmology
Plastic Surgery
Allergy and Immunology

Background:

Blepharochalasis, characterized by eyelid edema and laxity, can lead to functional impairment.
Multiple chemical sensitivity (MCS) is a chronic condition affecting multiple organ systems, potentially complicating surgical outcomes.
Standard blepharoplasty techniques, including aponeurotic fixation, are typically employed for ptosis correction.

Observation:

A 29-year-old male patient presented with blepharochalasis and a history of multiple chemical sensitivity (MCS).
Following a standard blepharoplasty with aponeurotic fixation, the patient experienced a recurrence of palpebral ptosis within three months.
The patient underwent further surgical interventions to address the recurrent ptosis.

Findings:

Keywords:

Blepharochalasis immunoglobulin A immunological abnormality multiple chemical sensitivity

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Recurrence of eyelid ptosis after initial blepharoplasty is a recognized complication, particularly in patients with underlying systemic conditions.

Additional surgical procedures were necessary to achieve satisfactory and sustained improvement in eyelid function and aesthetic appearance.

The patient's eyelid function and cosmetic outcome improved after the stepwise surgical approach.

Implications:

Patients with concurrent blepharochalasis and multiple chemical sensitivity (MCS) may require tailored surgical strategies.
A stepwise surgical approach, involving staged interventions, may be more appropriate for managing ptosis in this patient population.
Further research is warranted to elucidate the specific challenges and optimal management protocols for blepharochalasis in patients with MCS.