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Hypothyroidism is a multisystem disease that affects the skin. This condition is common, with a lifetime risk of overt or subclinical hypothyroidism of 4.6% to 9.5%.1 It is 2 to 3 times more common in women than in men, and typically presents after age 45 years. Symptoms are nonspecific and can manifest as facial aging.1,2 Klatsky and Manson2 reported a 2.6% incidence of undiagnosed hypothyroidism in patients seeking aesthetic intervention for periorbital aging, manifested by edema, festoons, and secondary bags.
Langsdon PR, Tompkins JJ, Goodman RC. Hypothyroidism as a Risk Factor for Prolonged Postoperative Edema Following Face-lift Surgery. JAMA Facial Plast Surg. 2016;18(4):315-316. doi:10.1001/jamafacial.2016.0155