By Dr. Raymond Douglas, MD PhD
Graves’ disease, along with its associated thyroid eye disease, doesn’t solely affect the eyes. This autoimmune condition can also target tissues in the cheeks, brows, and lower face, causing them to expand and change shape.
Many patients are puzzled by the transformations in their facial features, noticing bulging or a change in contours they’ve never experienced before. The culprit? Thyroid eye disease-induced fat expansion. This expansion can sometimes be localized, resulting in asymmetrical changes in facial appearance.
Let’s explore some common manifestations of these facial changes and potential solutions.
Overview of Graves’ Disease and Facial Changes
Graves’ disease is an autoimmune condition that affects the thyroid, a gland that produces hormones that regulate the body’s functions. When the immune system attacks the thyroid, it can cause the overproduction of thyroid hormones (hyperthyroidism). This affects the metabolism but also physical appearance, particularly the face.
Graves’ disease can cause the swelling of facial tissues and bulging eyes due to fat expansion, changing the shape of the face over time. The thyroid can affect the muscles and fat around the eyes and create a distinct look that can be distressing for patients.
Symptoms of Graves’ Disease in the Face
The facial changes associated with Graves’ disease vary but are often linked to thyroid eye disease (TED), which affects many Graves’ patients. The common facial symptoms of Graves’ disease are:
- Bulging Eyes (Proptosis): One of the most noticeable changes is the bulging of the eyes, also known as exophthalmos. This occurs when the muscles and tissues around the eyes swell, and the eyes protrude.
- Swollen Eyelids and Puffiness: The eyelids may be swollen or puffy, affecting both the upper and lower eyelids and giving a tired look.
- Skin Changes: Some patients experience skin changes, such as the skin becoming thicker or swollen in some areas.
- Puffiness in the Cheeks: The expansion of fat in the cheek area can cause puffiness and make the face look rounder or uneven.
How Does Graves’ Disease Affect Facial Appearance?
Graves’ disease can significantly change your facial appearance. The most common changes are swelling or puffiness, especially around the eyes and cheeks. The expansion of fat in these areas can change the shape and symmetry of the face and make it look bulging or protruding. Graves’ disease can also affect the skin texture, making it thicker or swollen. These changes can be distressing but can be managed with the right treatment.
What Are the Facial Changes Associated with Thyroid Disorders?
Different thyroid conditions affect the face differently. In Graves’ disease, facial swelling and bulging eyes are the most prominent features due to thyroid eye disease (TED). Hyperthyroidism causes weight loss, increased sweating, and thin skin but doesn’t always cause the dramatic facial changes seen in Graves’ disease. Hypothyroidism causes facial puffiness, especially around the eyes, and can make the skin look cool or pale. Knowing the differences between these conditions is important for accurate diagnosis and treatment.
Facial Areas Affected by Graves’ Disease
Graves’ disease can affect different parts of the face and cause noticeable changes. Below are the areas affected and the changes:
- Eyebrow Region: Some individuals may observe an expansion in the eyebrow area, resulting in thicker, fuller brows that alter their appearance. While removing fat from this region poses challenges, strategic sculpting or filler injections can help achieve a more balanced look.
- Upper Eyelids: Fat bulging in the upper eyelids can be bothersome. While surgical intervention may be necessary to sculpt the fat in this delicate area, it’s crucial to consult with a specialist experienced in managing Graves’ disease-related facial changes for optimal outcomes.
- Lower Face: Graves’ disease often profoundly affects the lower cheek area, leading to significant changes in facial contour and shape. Though the exact mechanism remains unclear, various surgical and non-surgical options are available to address it. Surgical procedures, such as fat removal through intraoral incisions, can restore contour and symmetry to the lower face. Alternatively, non-surgical treatments like Kybella and filler injections offer less invasive solutions with remarkable results.
Treatment Options for Facial Changes
For patients with facial symptoms of Graves’ disease, there are several treatment options. Depending on the severity of the changes, treatments may include:
- Surgery: Surgical procedures like blepharoplasty (eyelid surgery) can remove excess fat and skin around the eyes. Fat removal from other areas of the face, like the cheeks, can also restore symmetry.
- Steroid Therapy: In some cases, steroids are prescribed to reduce inflammation and swelling of the facial tissues.
- Non-Surgical Options: Treatments like Kybella (fat-reducing injection) or dermal fillers can reshape areas of the face affected by Graves’ disease. These less invasive options provide remarkable results with minimal downtime.
- Lifestyle Changes: Managing stress, eating a balanced diet, and exercising can improve overall health and reduce symptoms of Graves’ disease. These lifestyle changes may not reverse facial changes but can support long-term thyroid health.
Long-Term Management and Outcomes
Long-term management of Graves’ disease facial changes requires a holistic approach. Patients may need ongoing care to manage hormone levels and periodic treatments for facial changes. In some cases, facial swelling or bulging eyes can persist even after thyroid levels stabilize, requiring regular checkups with healthcare providers. Long-term solutions like surgery or periodic injections may be part of a patient’s management plan to maintain facial symmetry and skin health. Regular follow-ups with specialists experienced in Graves’ disease are key to the best results.
Take Action with Raymond Douglas, MD
If you are struggling with the facial changes caused by Graves’ disease, you need to see a specialist who knows how to manage these symptoms. Raymond Douglas, MD, PhD is an expert in Graves’ and thyroid eye disease and offers the latest surgical and non-surgical treatments to restore your facial appearance. His personalized approach ensures every patient gets the care they need for the best results. Contact Dr. Raymond Douglas today to find out how he can help.
