Two prior studies (2011, 2018) histopathologically compared the eyelid specimens of patients with dermatochalasis (undergoing blepharoplasty) with a control group and proposed that dermatochalasis may begin with subclinical inflammation leading to elastolysis and secondary lymphostasis. If such changes differ at different ages is not clear which is the aim of this study.

In a prospective comparative study, 20 right upper eyelid skin of 20 non-smoker, class III Fitzpatrik skin type women (30-68 years old) at 4 age groups (≤40, 41-50, 51-60, ≥61 years) were histopathologically examined. Upper eyelid skin was preoperatively marked, intraoperatively removed, postoperatively divided into 3 zones: lateral (lateral limbus to lateral canthus), central (between medial and lateral limbi), and medial (medial limbus to medial canthus), and were separately (totally 60 specimens) sent for histopathological examination. A masked pathologist recorded skin thickness in all specimens (60) as well as lymphatic vessels diameter and density, elastic fiber density, macrophage number, collagen intra-fibril edema, and depth of collagen stromal bed in central zones (20 specimens).

Each age group consisted of 5 right upper eyelids. There was not a statistically significant difference between different age groups and zones regarding all the histopathological measurements. A modest negative correlation was found between macrophage number and lymphatic fiber density.

None of the histopathological characteristics of dermatochalasis was altered by age. Results of this study support the idea that dermatochalasis is not simply an involutional disorder.