Eyelid Surgery: How the Procedure Works

The natural ageing process causes the skin to lose elasticity and the connective tissue to become weaker. At the same time, genetic predispositions, pronounced mimic muscle pull, UV radiation, smoking or lack of sleep can accelerate the slackening of the eyelids. Over the years, fine lines, sagging skin areas and, in part, bulges of fat tissue develop, which become visible as tear sacs. In some of those affected, functional problems also occur: a strongly slackened upper lid can restrict the field of vision or cover the lid crease. The German Society for Plastic, Reconstructive and Aesthetic Surgery (DGPRÄC) describes these changes as common age-related phenomena which can, however, be very pronounced individually.

A surgical eyelid lift offers both aesthetic and functional benefits. By removing excess skin, tightening the tissue and, if necessary, reducing fat deposits, the gaze appears more open, more alert and younger. Functional complaints such as a narrowed field of vision or a heavy feeling on the upper lid can also be significantly improved. A realistic expectation is important: the operation can slow down the ageing process, but not completely stop it. A result once achieved, however, usually lasts for many years. In the long term, people benefit from a fresher expression without losing their natural facial expressions.

The first step is a detailed consultation. Here your wishes, expectations and medical prerequisites are discussed. The treating specialist examines the condition of the lids, the skin elasticity, the muscles and any fat deposits. A precise measurement of the lid crease helps to plan the individual incision optimally. As part of the consultation, complete information is also provided: possible risks, side effects, alternatives and the exact procedure of the operation are explained in detail. Before the eyelid lift, people should discontinue blood-thinning medication (such as aspirin), not consume nicotine and not irritate the skin in the eye area. In addition, written consent is required, confirming that all questions have been answered. This preparatory process is crucial in order to tailor the treatment safely and individually.

On the day of the operation, you arrive at the clinic and are first prepared for the procedure. This includes a photo documentation, the renewed marking of the incision lines as well as a short safety briefing. The local anaesthesia then follows, supplemented on request by a light sedative injection. As a result, most people experience the procedure relaxed and almost pain-free. The eyelid lift is performed on an outpatient basis and, depending on the effort, takes around 30–60 minutes. In the upper eyelid lift, the incision is made along the natural lid crease. After removing the excess skin and, if necessary, small fat deposits, the region is closed with the finest suture technique. In the lower eyelid lift, the incision can be made just below the lashes or – in younger patients – inside the lid. Here, excess fat tissue is mainly corrected and, if necessary, the muscle is tightened. After suturing, the lids are carefully cooled in order to reduce swelling. You then rest briefly and may leave the clinic on the same day – of course with all the important aftercare instructions.

In the first hours after the operation, swelling and a slight feeling of tension are normal. Cooling (e.g. with cool packs, not too cold) helps the swelling to subside more quickly. Bruises can remain visible for a few days, but usually disappear within one to two weeks. The sutures are usually removed after 5–7 days. During this time it is important to spare the eyes: no strenuous screen work, no rubbing of the eyes and no strong bending. Make-up should also be avoided for at least a week. In the first two to three weeks, sport, sauna, solarium and strong sun exposure should be avoided, as heat and UV light can impair healing. Light activities are possible after a few days. The final result becomes apparent after a few weeks, once the swelling has completely subsided and the scars have faded inconspicuously. Most of those affected appear noticeably fresher and more alert afterwards.

Like any surgical procedure, an eyelid lift also carries certain risks. These include swelling, bruising, infections, wound healing disorders or slight asymmetries. In rare cases, scarring or irritation of the conjunctiva can occur. Through a precise surgical technique, a sterile way of working and careful aftercare, however, these risks can be significantly minimised.

For people who do not want an operation or whose lids are only slightly slackened, there are non-surgical alternatives. These include laser treatments, radiofrequency therapy or the plasma pen. These methods tighten the tissue, but do not have the same durability as a surgical procedure. The results are usually moderate and have to be refreshed regularly. A detailed consultation helps in deciding which method can realistically achieve the desired effect.