In youth, the skin around the eyes is flawlessly smooth. The transition from the lower eyelid to the cheek follows a harmonious S-curve in the semi-profile. Eye wrinkles form when the skin's elasticity decreases. When the soft tissues of the face drop and lose volume, rings under the eyes, tear ducts or bags under the eyes form. Anti-wrinkle creams cannot stop this development. Wrinkles under the eyes make us look older than we feel. Shadows below the eyes make us look tired. The following changes can affect the radiance of the eyes:
Rings under the Eyes:
Rings of the eye develop at the border between two different fat pads: the fat pad behind the eye ring muscle and the fat pad of the eye socket. Between these fat pads lies a band that connects the skin with the lower edge of the eye socket. The superficial fat pads of the face shift downwards with age according to gravity. In the area of the ligament an arch-shaped retraction develops, which is called an eye ring. A swelling of the tissue can increase the appearance of rings under the eyes.
Lacrimal glands develop similarly to rings under the eyes. The depression runs below the inner corner of the eye between the eye ring muscle, the lifter of the upper lip and the nostril and the lifter of the upper lip. Tear channels are called "nasojugal groove" or "tear trough deformity". As with rings around the eyes, the treatment is carried out by loosening a band at the lower edge of the eye socket. In addition, a tear groove is corrected by loosening the above-mentioned muscle attachments and a free transplantation of a fatty body.
Lachrymal sacs are caused by a loss of volume of the deep fat pads of the face and the sinking of the fat pad behind the eye ring muscle. The skin is firmly connected to the cheekbone by a ligament. The fat pad above lies over the ligament and leads to a bag-shaped bulge. The English term for bags under the eyes is "festoons" or "malar bags".
In the initial stage, these changes only become visible through fluid shifts in the evening or in the morning. Sleep, rest, healthy nutrition, sport and good skin care are important. A correction of the lower eyelid can alleviate or eliminate this sign of aging or family predisposition.
An eyelid lift removes excess skin and muscle. During lower eyelid correction, excess fatty tissue can be removed. To soften the shadows of tear lines and correct the contours of bags under the eyes, the fat pads are moved over the lower bone edge of the eye socket. The scar is partially covered by the lower eyelashes and can be hidden at the outer eyelid angle in the laugh lines. If there are no eye wrinkles, the correction is performed on the inside of the lower eyelid (transconjunctival). There is no scar visible from the outside.
Immediately before each operation, the surgeon talks to you again. The entire surgical team checks several times whether all requirements for maximum patient safety have been met. The operation is not started until the surgeon, the anaesthetist and the surgical specialists give the go-ahead.
During a twilight sleep, you will be given medication that will take away your fear and reduce your sensation of pain. Before this, the surgeon marks the planned skin incisions and checks the planning of the operation again. The local anaesthetic contains adrenaline to prevent bruising (tumescence technique). The injection takes place into the nearer eye area and the lower lid. Within five to ten minutes the surgical area is numb. If you are not already sleeping deeply, you may feel something happening in your eyes. The surgeon wears magnifying glasses in order to be able to work with maximum precision. If there is excess skin on the lower eyelid, access is made parallel to the edge of the eyelid up to the laugh lines. The underlying fat pads are redistributed if necessary. If the lower lid is flaccid, the eyelid band is fixed to the periosteum of the lateral eye socket. The excess skin is gently removed. Rings of the eye without excess skin are corrected via an access on the inside of the lower eyelid. Finally, the wound edges are sutured and a small bandage is applied. The anaesthesia continues beyond the operation. The operation of both lower eyelids takes about 90 minutes.
Immediately after the operation you will be continuously monitored in a recovery room. The eyes are cooled. After the complete awakening you will get something to drink and, if you tolerate it well, also something to eat. Before you leave the practice, appointments for check-ups will be made and the behavioural measures will be discussed with you in detail. You will receive an extensive written report and a telephone number. The surgeon can be reached at this telephone number 24 hours a day.
Fractionated CO2 laser treatment
A laser treatment reduces wrinkles and the smallest eye wrinkles. The effect of a laser treatment is limited to the skin surface. The skin is smoothed for about two years. Laser therapy is not suitable for bags under the eyes, rings under the eyes and tear ducts. We are happy to recommend specialists for laser therapies to you.
Eye circles injections
Deepenings under the eyes can be concealed with hyaluronic acid. The skin around the eyes is the finest on the whole body. There is therefore a danger that palpable and visible irregularities of the skin will remain. The body degrades hyaluronic acid over time. The effect of fillers fades after twelve to eighteen months.
PRP against eye wrinkles
A PRP treatment, especially in combination with a microneedling, leads to an increase and renewal of the cells of the epidermis. Different types of collagen and elastin are essential building blocks of connective tissue. The proportions of the various collagens in the skin are improved and the elastin content is increased. The blood supply to the skin also increases. We recommend a plasma treatment and a microneedling for young patients, for mild lacrimal glands or dark circles as well as for small skin wrinkles.
Botox against eye wrinkles
Botox reduces dynamic wrinkles. A Botox treatment is particularly effective against crow's feet. Eye circles, tear lines or eyelid wrinkles cannot be corrected sensibly with Botox.
- All your questions about possible complications and alternative treatments should be answered before the operation.
- Keep nicotine and alcohol consumption to a minimum.
- Blood-thinning medication (e.g. ASS, Thomapyrin®) must be discontinued ten days before the operation after consultation with your doctor.
- The intake of hormone-containing medication (the pill) must be temporarily stopped.
- Stop taking vitamin preparations (A, E) and dietary supplements (e.g. omega-3 fatty acids, St. John's wort preparations) four weeks before the operation.
- Leave cooling pads or goggles at home to cool your skin after the operation.
- At first you will be sensitive to the sun. Bring dark sunglasses with you to the operation. Of course it also hides the inevitable postoperative swelling.
- Surgery limits the suitability for air travel. Do not plan any professional or private air travel in the four weeks following the operation.
- Take out follow-up insurance before an aesthetic operation.
- You may drive a car as soon as you have regained your unrestricted view. On the day of the operation, driving should be strictly avoided simply because of the accompanying medication.
- Your well-being and the result of the operation will be checked regularly.
- A lot of rest and cooling of the eye help to keep the swelling to a minimum during the first three days. Use light cooling pads or cooling glasses.
- Adherence to the hygiene rules ensures your operation results to a high degree. Your hands should be washed regularly with liquid soap for 30 seconds. Avoid contact with animals.
- An elevation of the upper body of about 30 degrees (also during sleep) over five days is beneficial for decongestant and wound healing.
- The swelling can cause you to be unable to close your eyes completely on the first day. Use eye drops or gel for a week to prevent the conjunctiva from drying out.
- The skin threads are removed on the fifth postoperative day. Avoid applying make-up to the scar during the first week.
- Do not use contact lenses for the first week. Avoid reading, watching television or working at the computer, as this reduces the blink of the eye and thus less moistens the still slightly irritated conjunctiva.
- After about one, better two weeks you can go back to work. By then the swellings and the coarsest effusions have disappeared.
- From the third postoperative week onwards, several daily circular massages for a few minutes as well as lengthwise and crosswise to the course of the scar with oily creams (e.g. Bepanthen® ointment or Linola® fat) help to inconspicuous scars.
- Avoid bending over, lifting heavy loads, swimming, saunas, and sporting activities for three weeks. If swelling still exists, a longer period of rest may be advisable.
- Excessive UV radiation (solarium/sunbathing) should be avoided for at least three months.
- Smoking prevents the transplanted fat cells from healing and increases the risk of inflammation and thrombosis. Avoid smoking tobacco and e-cigarette for six weeks after surgery.
We focus on the expression of your eyes. Your appearance will be fresher and more rested with a lower eyelid lift. However, you do not become another person. A good result means that your fellow human beings notice that you look better without any sign of an operation.
From the age of forty, the first signs of aging usually appear on the eye. In exceptional cases, genetic influences can occur earlier.
Unfavourable conditions for lower eyelid correction are dry eyes, thyroid diseases and taking blood-thinning medication.
For an aesthetic and natural result, we first ask you about your wishes for change. Skin wrinkles, rings under the eyes, tear ducts and bags under the eyes can give a tired and tired impression. Dr. Santos Stahl will ask for information on the following topics in order to identify and prevent any risks in good time:
- vision defects (correction through glasses or contact lenses)
- pre-existing conditions (high blood pressure, diabetes, clotting disorders, thyroid disorders, glaucoma)
- Pre-operations, in particular eye operations
- Allergies and
- Medication intake.
Please let us know if you smoke or take dietary supplements. These factors have an important influence on your operation.
The skin, the fissure of the eyelid, the symmetry, the position of the eyebrown, the position of the eye and the elasticity of the eyelid are carefully examined. The power of the eyelid lifters is measured. The elasticity of the lower eyelid and the function of the eye muscles are checked. Your surgeon will discuss the possibilities and limitations of the treatment with you. The surgeon will show you various treatment alternatives and the associated risks and limitations. Eye circles, crow's feet, frown lines, wrinkles between the ala of the nose and the corner of the mouth (nasolabial folds) or bulging fatty tissue affect the appearance. For a harmonious overall result, every change should be treated specifically. During the interview you will receive all the information you need to decide which treatment is right for you. It is very important to discuss your expectations openly with your surgeon. Often a poorly informed patient or surgeon is the cause of an unsatisfactory result, even if there are no complications during the operation.
Dr. Santos Stahl will discuss all the details of the procedure with you, including the type of anaesthesia used, follow-up insurance, preparation and post-operative behaviour. She will explain to you in a transparent and comprehensible way how the costs of labia reduction are made up.
If you are unsure or do not feel fully informed, do not hesitate to ask your doctor questions. It is not uncommon for questions to come in the aftermath. At the end of the first consultation we will gladly offer you a second consultation. It is very important to us that all your questions have been answered before the operation.
If you suffer from dry eyes, we recommend that you have a so-called Schirmer test carried out by an ophthalmologist.
The eyes have a decisive influence on the facial expression. The removal of rings under the eyes, bags under the eyes or tear ducts makes you look fresher and younger. The removal of eyelid wrinkles rejuvenates the entire facial expression. The correction of bags under the eyes helps to achieve a harmonious transition from the lower lid to the cheek.
Despite all care in planning and execution, complications may occur during and after the operation. If necessary, this may result in further treatments, measures and operations. In general, there is a higher risk of surgery for smokers, blood sugar disease and obesity and a lower risk for non-smokers, healthy and normal weight patients.
Tissue irritation during surgery or disinfection can lead to swelling of the connective tissue. The swelling usually disappears as a result of rest and cooling. An accompanying drug treatment may be necessary. Irritation of the cornea by disinfectants can lead to temporary blurred vision. In the unlikely and very rare case of bleeding behind the eyeball in the first few hours, the optic nerve must be surgically relieved immediately. Scar healing takes six to twelve months. As a rule, scars are pale, soft, painless and flat after one year. Side differences, which exist in every human being, can cause a slightly different scar course or skin wrinkles even after the operation. In the case of a flaccid eyelid frenulum, the lower eyelid may be protruding due to scar shrinkage. A tightening of the eyelid band helps to keep the risk low. Injury to the lacrimal duct or distortion of the lower eyelid can lead to a disturbance in the flow of tears or dry eyes. Irritation of the nerve below the eye socket can be accompanied by numbness. Usually the numbness disappears by itself after a certain period of time. The relationship between the fat posters in the lower eyelid and the oblique lower eye muscle causes a risk of injury. Eyelid lifting is one of the five most common aesthetic operations performed worldwide. Compared to the most common aesthetic operations, eyelid lifting is one of the least risky procedures.
The following remuneration components must be taken into account when correcting the lower eyelid:
- VAT of 19%.
- Remuneration for Plastic Surgery
- Medical anaesthesia services
- Nursing services required within the framework of the treatment
- Consumables required during the above procedure
- consequential cost insurance
- The operational wound controls
- Long-term operational controls
- Permanent availability of the surgeon in the two weeks after the operation
Many patients compare different offers before an operation. For a direct comparison, all expenses including aftercare must be taken into account. The training, experience, skills and scientific competence of a physician are more difficult for a layman to compare than the costs. Ask about the qualifications of the doctor you trust. The terms "cosmetic surgeon", "aesthetic surgeon" or "cosmetic surgeon" are not protected. The situation is different with the professional title "Plastic and Aesthetic Surgeon", these physicians have all completed an appropriate six-year training course. This is similar with ear, nose and throat specialists and oral and maxillofacial surgeons, who can acquire the additional qualification "plastic surgery" after two years of further training and are thus qualified for operations in the area of the head. The medical activity also includes research, for example in the context of a medical doctorate or habilitation. The ability to incorporate scientific findings into rational treatment decisions is strengthened by independent scientific work. The professional experience in a leading position strengthens the sense of responsibility and the competence to solve complex and difficult challenges. The costs of treatment are relevant for decision-making, but trust in the doctor should ultimately be decisive.
Unfortunately, it is not possible to give an exact price without an examination because, among other things, the scope of treatment and possible pre-existing conditions and/or pre-treatments cannot be taken into account. We can therefore only tell you the exact costs after an examination as part of the consultation. We will also be happy to advise you on financing options without obligation.
According to § 1 paragraph 1 no. 2 of the Heilmittelwerbegesetz, the comparative illustration of the success of treatment by before/after photographs may not be published on the Internet. Nevertheless, before/after images can be used to inform patients. We will be happy to show you before/after images as part of a personal consultation in order to show you the possibilities and limitations of cosmetic surgery. It goes without saying that we comply with all legal data protection regulations.
Brazil has been a pioneer in aesthetic surgery for decades and is considered the cradle of cosmetic surgery.
Dr. Santos Stahl completed her specialist training in Brazil with first-class surgeons. Later, Dr. Santos Stahl obtained the German and European specialist qualifications. She specialized for 4 years in the field of facial surgery in Stuttgart and another year in the field of ear surgery in Paris. Dr. Santos Stahl has also expanded her spectrum and knowledge with the most influential plastic surgeons in Dallas, Oakland and Salt Lake City - thanks to a scholarship from Germany's largest association of plastic surgeons (VDÄPC).
Dr. Stahl studied eyelid correction with one of the world's leading plastic surgeons: Mark Codner, MD (https://www.markcodnermd.com). PD Dr. Stahl was appointed Senior Physician and Permanent Representative of the Medical Director at the University Hospital of Tübingen in 2015. From 2016 to 2018, he moved to Lüdenscheid as hospital director. Over the years, Dr. Stahl has continued to refine his microsurgical techniques so that today he enjoys a reputation among experts as a particularly gentle and precise surgeon. Various scholarships have led him to outstanding cosmetic surgeons in Brazil, New York, Atlantla and Salt Lake City.
Medical decisions and recommendations must be made on the basis of proven efficacy. The scientific competence of a physician is important for assessing the significance of a scientific proof. An additional qualification as an investigator and experience in conducting clinical trials is advantageous for this. These requirements apply to Dr. Santos Stahl and PD Dr. Stahl.
We systematically examine and compare the appearance, well-being and satisfaction of our patients after an operation. This includes not only uniform photo documentation, but also satisfaction with the contours and skin of your lower eye area. At the same time, we also systematically check the possible influence of the procedure on the perceived self-confidence and attractiveness. We encourage our patients to rate us on Jameda and Google. Many patients are willing to share their experience with other patients to help them make the right decision. During the consultation we are happy to put you in touch with these patients.