Rejuvenate your Eyes with Eyelid Surgery or an Eye Lift
Put the Sparkle Back into your Eye with Eyelid Tightening
Overview of Eyelid Correction
|Indications for Surgery||Consequences of ageing, Congenital and acquired misalignments, Consequences of injury|
|Treatment Period||1 – 3 hours|
|Anaesthetic||Depending on scope and wish: Local or general anaesthesia|
|Patient Stay||Depending on scope and wish: Out-patient or in-patient in our Clinic located in Germany|
|Inactive Period||1 -2 weeks|
|Costs||Depending on scope: Usually € 1000 – € 4500 plus VAT|
|Sport||After 1 – 3 weeks|
Drooping Eyelids can make a Face Look Tired
When one meets another human being, contact is first established via the eyes. They are the primary and an important means of communication, and make a first and significant impression, whether good or bad.
Eyes can appear wakeful, attentive, alert, radiant and youthful or tired, lacklustre, old and sad. That is why they are so important for our outward appearance and our self-perception.
Causes for Drooping Eyelids
Eyelid skin is very thin: 0.4 mm in contrast, for example, to the back’s skin, which is ten times as thick. It has to be so fine and thin, because it needs to be extremely movable in order to open and close the eyes quickly.
That is also why it is particularly sensitive to life changes resulting from ageing as well as injury.
How are Hanging Upper Eyelids and Tear Sacs Created?
The consequences of ageing are manifested on the upper eyelids in the form of redundant folds, so-called hooded eyelids, a condition known as blepharochalasis: These folds occur when the skin slackens and its surface increases excessively as a result. The excess of skin can be so significant that it starts drooping over the eyelashes. This can impair vision. In addition, the fat situated around the eyeball at a young age is pressed forward to bulge the excess skin, thus making the upper lids full and thick. These symptoms can be removed through plastic surgery involving correction of the eyelids.
What the upper eyelids experience also occurs, in principle, on the lower eyelids, except that it is known by the different name of “bags” here: In this case, too, the fat falls forward to result in a fatty prolapse which forms these bags. As an added consequence of these fatty deposits, folds appear in the skin.
Another change here occurs in the form of a furrow between the lower eyelid and cheek, under the lacrimal sac, known as the tear trough. In other words: The aged lower eyelid consists of the lacrimal sac and tear trough.
Which misalignments exist The upper eyelid can exhibit ptosis, involving a mostly one-sided drooping of the lid. This can be congenital or acquired. The lower eyelid can exhibit ectropion, in which case the eye does not fully close.
Injuries can have consequences of all possible forms which affect health. Not all of these changes improve by themselves. The problem is solved by eyelid surgery, also called blepharoplasty.
Objective of Treatment for Eyelid Lifting
Eyelid correction is intended to rejuvenate the eye region and, hence, the person in general appear fresh, wakeful, attentive, alert, radiant and youthful, whilst restoring their good looks. Eyelid tightening or brow lift is needed here.
Course of Treatment
Surgery on the upper eyelid is usually ambulatory and performed under local anaesthesia. Indicated here is upper eyelid tightening to eliminate hooded eyelids. General anaesthesia is possible if desired. The patient comes to us, undergoes surgery and then returns home with everything they need, ideally accompanied by someone. They need: Instructions on what to do, contact person’s mobile number, cold compressions and a follow-up appointment the next day.
A pair of sunglasses can be used to hide the after-effects of eyelid tightening surgery: Bruising and swelling. The stitches are removed after a week. The obvious consequences of surgery have then receded, and one is socially presentable again. The final result takes three months.
The lower eyelid needs more time, expertise and effort. The anatomical structures here are more complex, the operation requires greater knowledge and skills.
This kind of surgery has two objectives: First of all, the “bag”, i.e. the prolapsed fat needs to be removed; secondly, it is necessary to correct the furrow which has arisen below the bag and is also unsightly. This is done using a trick: The excess fat of the bag is disengaged in the form of a tissue block, and moved down beneath the furrow. Both problems are thus solved at once, to achieve a nice, smooth, harmonious transition from the lower eyelid to the cheek.
The times in which only bag removal was performed should be over (though they are not). The result is a hollow, skeletonized lower eyelid region.
Lower eyelid surgery usually takes place under anaesthesia and involves an overnight stay at our clinic. The next day our patients in Berlin go back home, equipped with everything necessary. Here too, sunglasses help as a disguise.
The time of absence from public appearances is two weeks, the final result becomes evident after three months. Upper and lower lids, i.e. both eyelids together, can be operated together in a single procedure. Both problems are thus remedied together, the inactive period also being two weeks.
The eyelids are cooled after such surgery. You should sleep in an upright position and avoid draughts. Swelling reducing medicines: Bromelain speeds up return to normalcy. The pain is minor and easy to treat. A pair of sunglasses (a-la Jaqueline Kennedy) makes it possible to join the crowd again quickly. Stitches are removed after a week. Regular checks take place, the last one after three months.
There is no such thing as zero risk in the field of surgery! It is low if the surgeon is good and experienced.
What can happen here: The surgeon might remove tissue excessively, insufficiently or unevenly. This is avoidable by means of exact drawings before surgery. In case of doubt, it is better to leave too much than too little. Trimming is not a problem, but patching is.
If too much is cut away from the upper eyelid, it will not close. This must be prevented.
The lower eyelid might result in a watery eye, or ectropion. This must also be prevented. As an additional safety measure, the lower eyelid is therefore suspended by means of a seam from the lateral edge of the eye socket. Keyword: Tarsopexy.
When is Surgery not Recommended?
Surgery should not be performed if the patient is otherwise seriously ill. The surgeon must ask whether this is the case. Minimal changes to the eyelids do not justify surgery: It must be worthwhile; the difference between before and after must be evident. Diseases of the eye itself must be excluded, i.e. the eye’s vision as such must be unaffected.
Streamlining should not be performed if these conditions are not fulfilled.
Laser treatment has no benefits.
Reimbursement of Costs by Health Insurances
Surgery on the upper eyelid can be performed if the field of view is restricted by more than 50%. This can be determined through a measurement by the eye doctor. Otherwise, the patient must bear the costs.
The following authors have dealt in detail with this topic: A. M. Putterman, S. Fagien