Patients who have Graves eye disease are often told by doctors “Atleast it isn’t cancer”. As an oculoplastic surgeon in Denver who does not have Graves eye disease, I understand the concept that it is not cancer but there are few diseases of the eye that are so disfiguring and self-concious creating as Graves eye disease. The most common surgeries for graves are orbital decompression, strabismus or eye alignment surgery, and finally eyelid retraction surgery. That being said, in the goal of returning the patient to “normal” appearance there are several areas that can be cosmetically treated in patients with graves disease and different procedures that can be done. The different procedures are listed below and often it is recommended that these surgeries are done AFTER an orbital decompression and/or strabismus surgery is completed.

Lower eyelid Blepharoplasty

In this procedure excess fat from the lower eyelids are removed. The loose or baggy skin is also tightened.

Brow lifting/sculpting

In this procedure, the eyebrows are lifted and the fat that is increased in the brow area is sculpted or debulked. This removes the heaviness of the eyebrows of patients.

Upper eyelid Blepharoplasty

This procedure is done with caution if there is excess eyelid skin in the upper eyelids after eyelid retraction surgery is completed. Excess fat in the upper eyelid is often removed at the same time.

Halo/Profractional laser

This laser improves the skin quality of the patients with Graves who have thyroid dysfunction. Often low or high thyroid function can cause pore expansion or irregularities of the skin. These lasers are helpful to improve skin quality.

These are the most common four cosmetic procedures that patients with Graves undergo in my office in Denver. The one thing that is difficult is for insurance to cover these procedures. Unfortunately, medical insurance tends to cover procedures that help one see better or protect the eye and vision. They are very resistant to covering procedures that help patients look better. Graves patients often find it challenging bearing the costs of these cosmetic eyelid procedures but find getting back to their “original” selves as critically important. I think this would be the goal of anyone who developed Graves disease. It is almost impossible to return the patient to exactly how they looked before Graves. That being said, it often possible to return the patient to cosmetically acceptable appearance for them. Using these cosmetic tools along with the standards of graves disease (decompression, strabismus and eyelid retraction surgery) we can return patients back to looking their best.