Ascher syndrome unmasked: a rare cause of acquired blepharochalasis in a young female

Ascher syndrome is a rare, benign disorder typically identified by the triad of blepharochalasis, double upper lip, and occasionally non-toxic thyroid enlargement. Due to the variable presence and often isolated manifestation of its components, the diagnosis may be delayed or overlooked. In this report, we describe the case of a 31-year-old woman with a prominent double upper lip and bilateral upper eyelid laxity, the latter developing over years as a result of recurrent painless eyelid edema beginning in childhood. Clinical evaluation confirmed characteristic blepharochalasis and mucosal redundancy of the upper lip, with normal thyroid function and ultrasonographic findings limited to small asymptomatic nodules. Histopathologic examination of the excised eyelid tissue demonstrated hyalinized, acellular fibrous nodulation without neoplastic features, consistent with chronic post-edematous changes. The patient underwent successful upper eyelid blepharoplasty, achieving a favorable cosmetic result. This case emphasizes the importance of recognizing the constellation of findings suggestive of Ascher syndrome, even in the absence of overt thyroid involvement. Awareness of this rare condition allows for timely diagnosis and appropriate surgical planning, which are crucial for optimizing both functional and aesthetic outcomes.