The eyes and eyelids play a defining role in the face. It is no coincidence that, in many cultures, the eyes are considered the mirror of the soul. Eyelids may require treatment due to aging or for medical reasons. Specialists in eyelid surgery are board-certified plastic and cosmetic surgeons or ophthalmologists. They are extensively trained to achieve the best possible results.
Eyelid surgery is medically necessary in cases of tumors or eyelid deformities. However, there are also purely aesthetic reasons for undergoing eyelid surgery. Drooping eyelids can be corrected in this way. You can also have excess skin folds or age-related sagging of the lower eyelids treated.
Medically necessary eyelid procedures are covered by both public and private health insurance plans, as they are considered curative treatments. Cosmetic surgeries, on the other hand, are entirely out-of-pocket expenses. An exception is the reconstruction of facial features and eyelids following an accident.
What is cosmetic eyelid surgery?
Purely cosmetic eyelid surgery refers to surgical procedures on the eyelids, such as blepharoplasty, that are performed without any medical necessity. These procedures are usually intended to correct age-related changes in the eyelids.
One exception, for example, is excessive skin on the upper eyelid that restricts the field of vision. Examinations by an ophthalmologist using visual field testing objectively confirm this finding.
A successful outcome of plastic and aesthetic eyelid surgery is a natural, non-surgical appearance and an overall harmonious facial aesthetic. The treatment usually also results in improved function.
Upper Eyelid Lift (Blepharoplasty)
As people age, many experience upper eyelid ptosis (drooping eyelids), a condition that can run in families. In this condition, the upper eyelid droops, thereby narrowing the eye’s field of vision.
Because less light enters the eye, drooping upper eyelids can also contribute to chronic fatigue and exhaustion.
During surgery, an eyelid surgery specialist removes the excess skin from the upper eyelid. The specialist also removes the sagging muscle tissue and small deposits of fat, thereby tightening the eyelid.
In specialized clinics that routinely perform eyelid corrections, the procedure is performed on an outpatient basis under local anesthesia.
Pseudo-drooping eyelids result from a sagging forehead and eyebrow area, which makes the upper eyelids appear droopy.
An effective surgical technique is the forehead-brow lift to correct the upper third of the face. During this procedure, the surgeon lifts the sagging eyebrows back into place.
Lower Eyelid Correction
The lower eyelid has a very complex anatomical structure and “rides” on the cheek. It sags as part of the natural aging process. A specialist in eyelid surgery can gently and moderately lift it back into place.
They often combine this procedure with a lateral canthopexy to correct the age-related sagging of the cheek area.
The specialist should remove larger amounts of excess skin with the utmost caution, as otherwise excessive tension will be placed on the eyelid.
This can result in ectropion (protrusion of the lower eyelid margin, “droopy eye”). As part of lower eyelid correction, the surgeon can also gently remove protruding fatty tissue or tighten the slackened muscles.
The doctor should carefully weigh the options and risks of this procedure and discuss them with the patient. The result should look natural and as if no surgery had been performed, so that it blends harmoniously with the face.
Forehead and Brow Lift
The natural aging process leaves its mark not only on the eyelids but also on the rest of the face. Eyelid correction alone cannot always achieve a rejuvenated appearance when the forehead and brow areas have sagged.
The subcutaneous forehead-brow-temporal lift can eliminate nearly all signs of aging in the upper third of the face. For this procedure, the doctor makes a hidden incision along the hairline (“hairline cut”).
The forehead-brow lift is suitable for:
- Sagging eyebrows and small, tired-looking eyes
- Horizontal wrinkles
- Frown lines
- Crow’s feet, etc.
The forehead and brow lift is a complex procedure performed on the upper half of the face. It affects the aesthetic appearance of the entire face.
Only experienced specialists possess the knowledge and finesse required to perform this procedure with optimal results—ensuring the outcome is harmonious and complements the rest of the face.
Wrinkle Correction
To correct small wrinkles such as frown lines or “crow’s feet” in their early stages, you do not yet need to resort to surgical measures.
In these cases, you can achieve satisfactory results with botulinum toxin A (Botox) or hyaluronic acid injections.
The downside is that the effects of these injections are temporary. You’ll therefore need to repeat them at regular intervals.
An injection of hyaluronic acid in the eye area should target the correct layer of tissue; otherwise, there is a risk of irregularities in the skin’s texture. The skin is particularly thin in this area.
Which medical specialists are experts in eyelid surgery?
Specialists in eyelid surgery are board-certified plastic and aesthetic surgeons. Ophthalmologists who specialize in plastic-aesthetic or plastic-reconstructive eyelid surgery are also the right people to consult.
Membership in a professional society also ensures that eyelid surgery experts undergo continuous continuing education and provide treatment based on the latest scientific research findings.
These professional societies include:
- the German Ophthalmological Society (DOG),
- the German Society of Plastic, Reconstructive, and Aesthetic Surgeons (DGPRÄC), or
- the German Society for Aesthetic Surgery (GÄCD)
When selecting a clinic, make sure above all that the surgeons regularly perform such eyelid procedures. Be sure to receive comprehensive and personalized counseling before the procedure.
About the medical author
Dr. Christian Schrank
Medical Author
Dr. med. Christian Schrank – author: Explore expert medical articles in the Leading Medicine Guide.