Eyelid Lift: Information & Specialists in Upper and Lower Eyelid Lifts (Blepharoplasty)

An eyelid lift is a plastic surgery procedure that involves the removal of

• drooping eyelids,
• puffiness under the eyes caused by fatty tissue,
• fine lines around the eyes,
• sunken lower eyelids, or
• sagging eyelids

. The goal of the procedure is to achieve a uniform and symmetrical result.

The extent of the blepharoplasty depends on the individual condition of the patient’s eyelids. Removing the excess skin naturally results in the tightening of the skin and muscles.

Due to the natural aging process or a genetic predisposition,

• eye wrinkles,
• bags under the eyes, and
• sagging eyelids

. This leads to an undesirable change in the eye area and detracts from one’s ideal appearance.

Eyelid surgery is therefore almost always performed for aesthetic reasons. Most people opt for eyelid surgery because they want their eyes to look fresher, younger, and more radiant.

In extreme cases, however, changes in the eye area can also result in pathological visual field defects. In these cases, the procedure is referred to as a medically indicated blepharoplasty.

An eyelid lift removes drooping eyelids and wrinkles © Alessandro Grandini | AdobeStock

After an eyelid lift, the upper eyelids are noticeably smoother, making the eyes appear more open and radiant. The lower eyelids no longer have wrinkles at rest after an eyelid lift, though wrinkles do appear when smiling.

A fine, thin line remains in the natural eyelid creases, which is barely noticeable. However, an eyelid lift cannot lighten or firm dark or extremely thin skin on the lower eyelids.

Of course, an eyelid lift must not cause any damage to the retina or the back of the eye. Therefore, an ophthalmological examination is required before the surgical eyelid lift.

The results of this preliminary examination must be submitted to the clinic before the blepharoplasty is performed. In the two weeks leading up to the surgery, the patient must avoid

• sleeping pills,
• pain relievers that inhibit blood clotting, such as aspirin, and
• alcohol

.

To prepare for the post-surgery period, the patient should obtain two to three soft ice packs or a migraine mask.

On the day of the surgery, the patient should arrive without makeup, well-rested, and bring a pair of dark sunglasses.

Before the actual blepharoplasty, the oculoplastic surgeon first plans the optimal incision lines for the procedure. To do this, he or she draws a precise sketch on the patient’s skin with a pen.

An eyelid lift is usually performed on an outpatient basis under local anesthesia. The patient first receives a sedative injection to alleviate nervousness and anxiety. The medication puts the patient into a sort of half-sleep. Local anesthesia is then administered via four tiny, barely noticeable injections in each of the four eyelids. 

The plastic surgeon then uses a scalpel to remove

• excess skin from the upper and lower eyelids,
• deposited fat, and
• sagging muscle tissue.

As a rule, the amount of excess skin removed is roughly what can be grasped between two fingers.

Finally, the incisions are sutured intradermally with continuous, extremely thin sutures. This type of surgical blepharoplasty takes one to one and a half hours.

Immediately after the surgical eyelid lift, the patient can leave the clinic. Anxious patients can also opt for the procedure under general anesthesia. However, this is associated with additional risks.

In the first one to two days after the blepharoplasty, swelling of varying severity usually occurs around the eyes. However, this subsides shortly thereafter. In addition, bruising may appear around the eyes, particularly on the lower eyelids. In most cases, this bruising resolves within 7 days.

The sutures from the incisions are usually barely visible as early as 8 days after the blepharoplasty. When the eyes are open, they lie precisely within the natural creases of the eyelids. If the incision extends beyond the outer edge of the eye socket, the additional scars—which are about 1 to 2 centimeters long—may remain red for a few more weeks.

Due to swelling, the eyelid slit may also appear slightly smaller for a few weeks after the blepharoplasty.

During the first week after blepharoplasty, no creams, ointments, or makeup should be applied directly to the eyes or the fresh scars. To conceal any bruising, dark sunglasses should be worn instead.

To relieve the swelling and speed up its resolution after the blepharoplasty, the patient can use

• moist compresses,
• ice packs, or
• migraine masks

. These should be applied to the eyes as often as possible for about 1 to 2 days. Residual blood around the sutures can be gently removed with a damp pad.

The sutures are usually removed at the clinic five days after the eyelid lift surgery.

Possible complications that may occur with a blepharoplasty include

• postoperative bleeding in the first two days after surgery,
• a slight protrusion of the lower eyelid,
• increased tearing,
• excessive scarring,
• mild dryness of the eyes, and
• in very rare cases, visual disturbances.

Protrusion of the lower eyelid after an eyelid lift

The lower eyelid may temporarily protrude slightly after a lower blepharoplasty. At the same time, increased tearing may occur. Both depend on the extent of bruising and scarring.

These complications occur primarily in older patients and following repeat procedures. If they do not resolve on their own within six weeks, they may require another minor procedure.

Scarring and Dry Eyes After Eyelid Surgery

Some patients are predisposed to excessive scarring. As a result, the incision lines may appear slightly thickened and reddened for several weeks.

It is normal for the eyes to feel slightly dry after an eyelid lift. However, if more severe irritation or redness of the eyes occurs, it is best to consult an ophthalmologist.

Preventing Complications from an Eyelid Lift

It is important to prevent complications during an eyelid lift. Therefore, the patient should inform the surgeon before the procedure if they

• suffers from any medical conditions or allergies—such as to medications or skincare products—or
• are prone to bruising and prolonged bleeding following minor injuries. This may indicate a blood clotting disorder.

1. When is an eyelid lift medically advisable?
Surgery may be necessary if sagging eyelids restrict the field of vision or impair eye function.

2. What are the risks associated with the procedure?
Possible risks of an eyelid lift include temporary swelling, bruising, a feeling of dryness, or, in rare cases, abnormal scarring.

3. Does health insurance cover the costs of this cosmetic procedure?
Health insurance generally covers the costs only if a medical necessity, such as a restricted field of vision, has been demonstrated.

4. How long do the results of an eyelid lift last?
The results of an eyelid lift are usually visible long-term, although the skin’s natural aging process continues.