Drooping eyelids have various causes. For example, they develop naturally with increasing age. As we age, the elasticity of the skin gradually decreases, including in the eyelids. These then follow the effects of gravity and begin to droop more and more. However, drooping eyelids only become medically relevant when, for example, eyelashes cause irritation in the eye or the affected person's field of vision is restricted by the drooping eyelid.
Drooping eyelids can also occur as a result of inflammatory diseases, too little sleep, high nicotine and/or alcohol consumption and water retention in the skin (oedema).
Drooping eyelids are excess skin on the upper eyelid @ FotoHelin / AdobeStock
Caution: If a drooping eyelid appears very suddenly, it may even be the result of a stroke. Those affected often also have problems speaking, symptoms of paralysis or drooping corners of the mouth. As a stroke is an emergency, you should call the emergency services immediately in such a situation.
From a medical point of view, drooping eyelids are a purely cosmetic problem in the majority of diagnoses. However, drooping eyelids are often associated with fatigue and exhaustion and can therefore become a real psychological burden for those affected. If you are bothered by drooping eyelids, you can have them treated or tightened by a cosmetic surgeon at your own expense.
The situation is different if drooping eyelids cause medically relevant secondary diseases. These include, for example, inflammation of the eye due to the eyelashes drooping into the eye. They also include eyelid malpositions and a restricted field of vision due to the drooping eyelid.
Tip: It is always advisable to apply to the relevant health insurance company for cost coverage before undergoing drooping eyelid surgery. This will check whether there is a medical indication and whether the procedure is therefore necessary and should be covered. There are also other therapeutic procedures that could be considered as alternatives to surgery. These alternatives to drooping eyelid surgery include
- Injections using Botox,
- laser treatment,
- ultrasound therapy or
- plasma pen therapy.
Blepharoplasty, or eyelid lift surgery, can in principle be performed on the upper and lower eyelid. However, the upper eyelid is most frequently affected. As the procedure is in many cases merely a cosmetic correction, eyelid lift surgery for drooping eyelids is not usually covered by health insurance. There is an exception, however, if the drooping upper eyelids are so pronounced that they restrict the field of vision. In such cases, there is a medical necessity for the operation and the procedure is usually covered.
The procedure takes around 20 minutes per side @ thomsond /AdobeStock
The operation is performed by a drooping eyelid specialist as an outpatient procedure under local anesthesia. The doctor draws the incision lines for the operation in advance. The incision lines follow the natural lines of the eye as closely as possible so that any scars are less visible later on.
In a blepharoplasty, excess eyelid skin is removed, parts of the fatty tissue can be removed or repositioned and the surgeon closes the eyelid again at the end. The drooping eyelid operation can be performed using a scalpel or laser, depending on expert experience.
Although laser surgery appears to be more advanced and patients would probably prefer this procedure, wound healing appears to be longer compared to traditional surgery with a scalpel. Laser eyelid lift surgery generates heat, which closes the blood vessels more quickly, which is probably an important reason for the somewhat slower wound healing after laser surgery. At the same time, the surgical wound also bleeds much less as a result.
The risks of the procedure to correct drooping eyelids are independent of whether it is a cosmetic or a medically necessary procedure. As with all wound procedures, the main risks are bleeding and infection. Some examples of common risks and consequences of a drooping eyelid lift:
- Bleeding,
- soft tissue damage,
- Sensory disturbances,
- Double vision,
- Visual disturbances, e.g. blurred field of vision,
- Infections and abscesses,
- conjunctivitis (inflammation of the conjunctiva ),
- scarring, keloids or
- disorders of the lacrimal flow.
Wound healing usually takes up to 14 days in the case of drooping eyelid surgery. During this time, care should be taken not to touch the wound area too much. In the first three days after the procedure, patients should also cool the wound. Sport and heavy physical work are also taboo in the first few days after the procedure.
Drooping eyelids and their correction belong in the hands of experienced specialists in the fields of ophthalmology, eye surgery and aesthetic or cosmetic surgery - depending on whether there is a medical indication for a drooping eyelid lift or whether it is merely a cosmetic procedure. Here you will find some suggestions for drooping eyelid specialists and suitable surgery centers.
