Eyelid lift / Blepharoplasty

Since the aging of the face is a natural process, the examination, in addition to the clinical assessment, is significantly concerned with discussing the patient's wishes and the goals to be realistically achieved. A qualified individual consultation will always aim at a harmony of the face to the whole. A comprehensive examination of your eye and inquiring about eye diseases are essential before surgery.

The condition of the surface of the eye (see dry eye) also plays an important role here. It should be noted that a dry eye will worsen after blepharoplasty surgery. 
Also, a slackening of the tissue in the forehead area with a subsequent lowering of the eyebrows must also be distinguished from pure drooping eyelids. If this eyebrow drooping is very pronounced, it can intensify the appearance of apparent drooping eyelids or cause a so-called pseudoblepharochalasis. In such cases, an optimal cosmetic result can be achieved surgically only in combination with a preceding forehead and brow lift.

Weakening of the eyelid elevator muscle can also lead to lowering of the lid ("ptosis") or neurological diseases ("facial nerve palsy") can contribute to asymmetries. 
Here are already stumbling blocks for a possibly wrong operation consultation by the inexperienced!

The planned outpatient procedure takes about 1 hour and is usually performed under local anesthesia and/or twilight sleep. Both anesthesia methods have their advantages and disadvantages, which will be discussed during the consultation.

The surgical procedure on the upper eyelid "drooping eyelid" includes removal of the excess skin adapted to your individual needs. Depending on the findings, additional removal of the protruding fatty tissue and correction of the eyelid furrow height may be necessary. Often, a tightening of the muscle lying annularly around the eye is also useful in order to achieve a long-term result. If necessary, an eyebrow lift can be performed through the same approach.

Lower eyelid surgery also involves skin, fat and muscle reduction, but often must be combined with tightening of the eyelid frenulum.

The aim of the operation is to achieve a natural, fresher and more open appearance of the eye area.
It is then purely a cosmetic operation. The surgical procedure depends decisively on your individual findings.

Surgical incisions are made in the natural folds of the eyelid so that the scars remaining after wound healing is complete are barely visible. Often, in addition to the removal of excess skin, tightening of the annular sphincter muscle to improve tension and moderate removal of protruding fat pads are required.

A lower eyelid lift is the surgical treatment of bags under the eyes. Depending on the degree of severity, different procedures are used here. If there is only a small amount of excess skin and the eyelid frenulum is not sagging, transconjunctival (= incision from the inside through the conjunctiva completely without an external scar) techniques are used, which only treat the lacrimal sac from the inside, usually by redistributing fat. If there is excess skin and a sagging frenulum of the eyelid, an incision on the outside of the skin directly below the eyelashes (= subciliar incision) is necessary. In addition to fat redistribution, tightening of the eyelid frenulum (canthopexy) and often tightening of the annular sphincter to improve tension and moderate removal of excess skin is always required here. Plaster dressing and cooling is done as described below.

Frequency per year: Reliable statistics on the frequency of eyelid lifts in Switzerland are not available. In contrast, according to statistics from the US Society of Plastic Surgeons, 149,943 eyelid lifts were performed in the USA in 2009.

For blepharoplasty, consultations with the general practitioner and the anesthesiologist are advisable.

The intake of so-called platelet aggregation inhibitors (e.g. acetylsalicylic acid-containing drugs such as aspirin and ASS) must be discontinued or changed at least 1 week, preferably 10 days, before the operation in consultation with the attending general practitioner. In the case of any existing Marcumar treatment, a change in medication must also be made in consultation with the attending general practitioner or internist.

It is advisable to stop smoking at least 1 week before and after the operation in order to avoid wound healing problems.

• Possible complications and risks from the treatment
• Swelling of the eyelids and surrounding skin
• Hemorrhage into the skin, muscles or fatty tissue (hematomas)
• Severe secondary bleeding into the eye socket or injury to the eye
  (e.g. after fatty tissue removal) have led to blindness in individual cases worldwide, therefore we only use a small plaster bandage, which allows us to perform clinical control
• Wound infection and separation of the wound edges
• Disturbances in wound healing (scarring)
• Allergic reactions (e.g. to medications, disinfectants, suture material, plasters) and irritation of the conjunctiva or cornea by disinfectants
• Overcorrection: excessive skin removal or scar traction after inflammation can lead to disorders of eyelid closure / tear flow
• Undercorrection: cosmetically insufficient result, which can be corrected by a new operation
• Asymmetry of the two sides: If too much fatty tissue is removed, cosmetically unfavorable depressions may take the place of the protrusion.
• Outward inversion of the eyelid margin (so-called ectropion formation). In this case, a longer patch treatment or a follow-up surgery may be necessary.
• Change in shape of the outer corner of the eyelid (from pointed to rounded shape)
• Dry eye

Immediately after the surgery, the fresh surgical sutures are covered with thin plasters. After eyelid correction, your eyes will be swollen and bruising is common. For this reason, you will receive cooling pads for your eyes after the procedure. In general, we recommend that you continue cooling several times during the first few days.

Physical activity, especially bending over, carrying heavy things and pushing, should be avoided during the first days after the procedure. Sauna and soaking the skin e.g. when bathing is not good for wound healing. Make-up and soap should be avoided in the eye area until the sutures are removed. Please avoid rubbing the eyelids.

The most severe swelling recedes within 7-10 days, although minor residual swelling may well persist for several weeks. The surgical scars also require several weeks, and only after 2-3 months can the result really be reliably assessed.

It is also advisable to avoid extensive sunbathing without sunglasses for 3-4 months after the operation (risk of increased pigmentation of the scar).

The skin stitches are removed on an outpatient basis after a few days. Here you will also receive advice on skin care and instructions for auto lymphatic drainage.

Please have someone pick you up after the surgery, as you are not fit to drive yourself.

During the first two days, support at home is worth considering. However, there is generally no severe impairment.

Patients complain less of pain in the first 2-3 days, which can be treated well with simple painkillers, than of the inevitable feeling of tightness and swelling.

Medications after surgery

In the first days after the operation, painkillers, which simultaneously have an anti-inflammatory and decongestant effect, are mainly taken. In addition, mild, decongestant medications on a herbal basis (such as Traumanase) are recommended for one to two weeks.

If only to feel more confident, the patient should follow the recommendations for follow-up treatment and keep the follow-up appointments. The complaints should improve quickly. In the event of deterioration - especially if pain increases on one side - the patient should contact the surgeon immediately. Therefore, it is also not advisable to leave the vicinity of the surgeon after only a few days.

Despite all care, complications or impairment of vision may occur. Also, even if only very rarely, life-threatening complications (for example due to anesthesia drugs) may occur, which require further treatment/surgery.

Our specialists and ophthalmologists will be happy to inform you in a personal consultation in our practice rooms.