Eyelid lift

This operation is so important because our communication in our daily interactions is very much through our eye contact. It has always been immediately recognisable to us if the person we are talking to seems tired, exhausted or sad, and this is often directly related to “heavy” eyelids. With increasing age, according to personally inherited genetics, the excess of upper eyelid skin increases continuously. This usually goes unnoticed up to a certain point – it is only when the skin rests on the lash line that the first problem arises: On the one hand, to open the eye we have to frown in order to lift the upper eyelid skin and thus allow the eye a clear view. For many patients, this can lead to tension in the forehead muscle area, which can lead to headaches. In addition, the constant frowning, over the years, causes forehead wrinkles to manifest, which is difficult to treat. Treatment, such as reducing the muscle movement of the forehead through Botox treatment, is usually not indicated in such cases. Due to the lack of facial expression, the brow cannot then be raised well.

On the other hand, a gradual lowering of the eyebrows takes place over the years. While in the area towards the nose the lowering is minimal, in the outer area, towards the temple, there is a steady lowering of the eyebrows. In many patients who have an excess of upper eyelid skin, there is sometimes also a partial drooping of the eyebrows. I would like to discuss this again in a later paragraph. The following is the recommendation to first perform blepharoplasty, followed by treatment with botolinum toxin of the forehead.

Upper eyelid blepharoplasty is, as mentioned above, a very common plastic surgery operation. Although it is a minor procedure compared to other operations, it is a very important indication. The secret of a good blepharoplasty can only be explained in a natural facial expression. The real difficulty of this operation is not the removal of skin muscle and fatty material, but rather, the special feature of this operation lies in the surgeon’s correct feeling, gained through long experience, to remove exactly those parts of the skin that cause the disorder. The result for our patients is a natural but more youthful, open and overall positive appearance.

This operation can be performed either under local anaesthetic or under a short sleep anaesthetic. In order to achieve an excellent result, it is important that our patients are physically calm and mentally relaxed. In this way, we as the surgical team are optimally supported by you and can perform this delicate operation perfectly. Since most patients naturally enter a surgical situation slightly tense, I usually recommend a short general anaesthetic in these cases. Here, a great advantage is that a consultant anaesthetist controls the peaceful sleep and ensures that we can work very precisely. During the anaesthetic, normal blood pressure and heart rate are ensured… these two factors alone greatly reduce the risk of bruising or haematoma.

After the operation, which lasts about 45 minutes, you will wake up and receive continuous cooling with a special face mask. This mask also reduces the risk of post-operative bleeding; it reduces swelling and, incidentally, also reduces pain. After about a week, i.e. after 5-7 days, the suture material can be removed, which is usually completely painless. The swelling caused by the healing process goes down quickly, so that after one week to ten days it is hardly noticeable to outsiders. The patients themselves usually feel that the operation is completed after 3-4 weeks. I do not recommend any special scar ointments for scar treatment, but I do recommend a high-quality and rich skin cream. During the post-operative healing phase, the use of eye drops without medicinal additives (= artificial tears) is highly recommended. In this context, increased active blinking is very important. This natural reflex is limited by the postoperative swelling, the suture material, possibly by small plasters and above all by the natural caution of the patient. The superficial cornea of the eye may dry out. This should be avoided at all costs as this drying is painful and requires further drug therapy.

Just like the upper eyelid lift, the lower eyelid lift is an important aesthetic detail towards a naturally youthful appearance. However, in contrast to the upper eyelid lift, this operation is subject to a somewhat stricter indication, as postoperative problems occur much more frequently here. Excess skin is also removed during this operation. In addition, excess fatty tissue from the lower orbital cavity can be reduced to achieve a more youthful facial expression. However, a lower eyelid lift should only be performed by doctors with a great deal of experience in eyelid surgery.

Many patients consult after a less than successful lower eyelid lift and ask for advice on how to correct and improve the results of the operation. The most common problem here is a previous excessive reduction of the skin and underlying muscles in the lower eyelid area. This can cause a permanent scarring of the lower eyelid margin, which is accompanied by a change in motor function, resulting in the formation of an ectropion. The possibilities of surgical reconstruction are given, but they are usually costly and lengthy.