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Eyelid surgery – a small procedure with a big effect
The more open our eyes look, the more alert and vital we appear. Upper or lower eyelid correction can achieve a harmonious rejuvenation of the whole face with comparatively little effort.
The eyes shape our facial expression like nothing else. When the eyelids droop, the whole face looks older, more tired and often sadder too – even if you feel fresh and rested.
Experience you cannot see
Eyelid surgery is one of my most frequent procedures: every year I perform more than 200 eyelid surgeries. I value this procedure because it is particularly effective – with relatively little effort, a very great effect on your overall appearance can be achieved.
There is no “standard” approach. I plan every eyelid surgery individually, because eyelid shape, excess skin and fat pads are different in every person. The shape of your eyes is preserved – you should still recognize yourself.
Upper eyelid surgery
Upper eyelid surgery (upper blepharoplasty) is advisable if the eyes appear visually smaller and look tired, or if the overhanging skin of the upper eyelid presses on the eyelashes (“hooded eyelids”). In pronounced cases, this can even restrict the field of vision.
I remove excess skin and – if necessary – part of the muscle or fat tissue. The incision lies in the natural eyelid crease, so that the scar is hardly visible after healing.
Lower eyelid surgery
Very good results can also be achieved with lower eyelid correction (lower blepharoplasty), for example for under-eye bags, slack skin or dark shadows caused by protruding fat pads. However, lower eyelid correction is more complex than upper eyelid surgery and requires many years of experience, including in reconstructive surgery. It therefore definitely belongs in experienced hands.
What you can expect
- Many years of experience and a high level of specialist medical expertise
- An outpatient procedure that takes no longer than a maximum of 90 minutes
- Inconspicuous scars in the natural eyelid crease
- No change to the shape of your eyes
- A long-lasting result
Upper eyelid: precision in detail
The strip of skin to be removed is marked precisely before the operation while you are sitting up, so that both sides are symmetrical. The suture tapers off laterally into a fine laugh line and is made with very fine threads. If needed, excess fat from the upper eyelid can be reused elsewhere – for example, for shadows under the eyes.
Health insurance: If the skin hangs down so far that the field of vision is restricted, upper eyelid surgery may be medically justified. A visual field test by an ophthalmologist is then the basis for an application.
Lower eyelid: two approaches
- From the outside: The incision lies directly below the lash line and extends a few millimeters into the lateral laugh line. Excess skin, bulging fat and slack muscle can thus be treated together; fat can also be redistributed to smooth the transition to the cheek.
- From the inside via the conjunctiva: For pure under-eye bags without excess skin, the fat is removed through the inside of the eyelid – without a visible scar.
On the lower eyelid, less is often more: if too much fat is removed, the eyes look hollow. If too much skin is removed, the eyelid can be pulled downward. This is where experience particularly shows.
Preparation
- No blood-thinning painkillers (such as aspirin, ibuprofen or diclofenac) for about two weeks beforehand – only after consulting a doctor.
- Avoid nicotine, alcohol and tanning beds during this time if possible.
- Pause dietary supplements shortly before the procedure.
- If you have dry eyes, it is important to have them checked by an ophthalmologist before the procedure.
When you should be particularly well informed
Dry eyes, multiple previous operations, connective tissue disorders or very high expectations require particularly careful planning. Glaucoma is not a reason for exclusion, but it requires close monitoring.
The process
- Consultation I examine your eyelids, skin and the area around your eyes and discuss whether the upper eyelid, lower eyelid or both should be treated.
- Preparation You receive advice on medications that affect blood clotting and on organizing the day of surgery.
- Procedure The operation is performed on an outpatient basis and takes a maximum of 90 minutes.
- Getting home Plan for someone to accompany you – you should not drive yourself on the day of surgery.
- Aftercare Cooling relieves swelling; the sutures are removed after a few days.
After the procedure
The result of eyelid surgery is visible almost immediately. Swelling and slight bruising generally subside within one to two weeks. Sunglasses offer protection during this time and conceal at the same time. Screen work is usually possible again after a few days; we discuss contact lenses, make-up and sports at your follow-up appointment.
Risks
Eyelid surgery is considered a comparatively low-risk procedure. Possible complications include, among others, secondary bleeding, wound healing problems, temporarily dry eyes, asymmetries or – particularly on the lower eyelid – a malposition of the eyelid margin. This is precisely why experience is so important. I discuss all risks with you in detail before the procedure.
Eyelid surgery: the process step by stepPreparation, the day of surgery and healing – with illustrations
Frequently asked questions
Will my health insurance cover upper eyelid surgery?
Generally not, as it is an aesthetic procedure. If the excess skin demonstrably restricts the field of vision, coverage may be possible. This usually requires an ophthalmologist’s report.
Is the procedure painful?
The operation itself is painless. Afterwards, there is usually only minor discomfort, which can be treated well with common painkillers.
When will I be socially presentable again?
Many patients feel comfortable in public again after about a week. This depends on the extent of the swelling, which varies from person to person.
Can eyelid surgery be combined with a facelift?
Yes, this often makes sense because together they create a harmonious overall appearance. More on this on the Facelift page.
Is the eye itself touched?
No. The surgery is performed on the skin, muscle and fat tissue of the eyelid – not on the eyeball. Vision may be slightly blurred temporarily due to ointment or slight swelling of the conjunctiva.
When can I exercise again?
Light exercise after about two weeks; intensive sports after lower eyelid surgery no earlier than after around four weeks.
When are the sutures removed?
Generally after about five to eight days – this is also the first detailed follow-up check.