The radiation of the eyes is measured yellow for the impression we make on others. The eyelash line, the eyelid crease and the eyebrows are in a harmonious interplay. Below the eyelid crease is the movable eyelid, above it the outer eyelid. The outer eyelid has a harmonious, slightly curved contour. The most important beauty feature is a balanced height ratio between the movable eyelid and the outer eyelid. In a drooping eyelid, the sagging skin covers the entire movable eyelid. The eyelid skin lies on the eyelashes and the upper lid feels heavy. The radiance of the eyes is lost. The eyes become smaller. A loss of fat on the outer upper lid leads to an inward curvature and a shadow above the inner crease of the eyelid. This change is called "A-frame deformity". The so-called "A-frame deformity" makes you look tired and older than you are. Apparently small changes play an important role in the first impression.
In the course of life, the elasticity of the skin and muscles of the eyelids diminishes. In a family predisposition, this change can occur before the age of forty. When the eyelid skin sinks, drooping eyelids form. During upper eyelid correction, a strip of skin and muscle is removed. The redistribution of fat pads and the use of nanofat help to achieve a balanced contour of the outer upper eyelid. The later scar of an upper lid lift can be hidden in the fold-over crease. The procedure opens the eye and helps to achieve a "fresher" appearance.
The safety of our patients comes first. For your safety, the surgeon, assistant and surgical specialist check all parameters several times before each operation. The operation does not begin until the safety checklist has been completed completely and correctly.
A light twilight sleep takes away your fear of the operation and reduces your sensitivity to pain. Before the operation, the surgeon marks the planned skin incision and checks every step of the planned operation. For maximum precision, the surgeon will operate with magnifying glasses. The local anaesthetic is injected into the eyelid. 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 adrenaline contained in the anaesthetic prevents bruising. The excess skin and muscle is gently removed with a scalpel. Sensitive handling of the tissue keeps the swelling to a minimum. According to the needs of the patient, excess fatty tissue is redistributed or nanofat is transplanted into the upper eyelid. Depending on the initial findings, the eyebrow can be raised. A small muscle (Musculus corrugator supercilii) can be removed from the inner corner of the eyelid to reduce the frown line. Various procedures can be combined to achieve an optimal aesthetic result. Finally, the edges of the wound are sutured. The anaesthesia continues beyond the operation. The operation of both upper eyelids takes about 45 minutes. You will receive a small bandage. It is important to cool the eyes after the operation.
Immediately after the operation you will be continuously monitored in a so-called recovery room. You can drink something after the complete awakening and, if you tolerate it well, eat something. 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 a report and a telephone number. The surgeon is available 24 hours a day after the operation.
- All your questions about possible complications and alternative treatments should be answered before surgery.
- 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. Driving should be strictly avoided on the day of the operation 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.
Upper eyelid lifting is one of the most common aesthetic operations for patients between the ages of forty and sixty. You will benefit from an upper eyelid lift if you suffer from a tired facial expression due to excess skin. If you have undergone laser treatment to correct a vision defect in the last six months, you should refrain from having an upper eyelid lift. An upper eyelid lift can intensify a pre-existing dryness of the eyes. If you suffer from dry eyes, be careful.
Eye circles, drooping eyebrows, crow's feet, weak eyelid lifter muscles, drooping lacrimal glands or bulging fatty tissue all affect your appearance. The surgeon will show you the treatment options for these changes in the consultation.
In order to achieve an aesthetic and natural result, we first ask you about your wishes for changes. If there is excess skin, your gaze may appear tired, severe or angry. In order to estimate the extent of the correction, it is very important to know whether you have had Botox treatment recently. In order to plan the follow-up treatment, you will be asked whether you suffer from ametropia, wear glasses or contact lenses.
Dr. Santos Stahl will ask for information on the following topics in order to identify and prevent any risks in good time:
- High blood pressure,
- Coagulation disorders,
- Pre-existing conditions such as thyroid disease, 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 a big 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. After a complete and thorough physical examination, Dr. Santos Stahl will discuss the removal of excess skin from the eyelids, which may include the removal or repositioning of fatty tissue. She will show you different treatment alternatives and the associated risks and limitations. Eye circles, drooping eyebrows, crow's feet, frown lines, a weakness of the eyelid lifter muscles, drooping lacrimal glands 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 the upper eyelid lift 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.
- An upper eyelid lift can make you look "rested" and "fresher".
- The scar of an upper eyelid lift is usually hardly recognizable in the crease of the eyelid.
- If you suffer from pronounced drooping eyelids, your field of vision may improve after an upper eyelid lift.
- Many patients lift their eyebrows to counteract the drooping eyelids. The constant tightening of the forehead muscles can lead to headaches that can be corrected by upper eyelid lifting.
- The stem cells of a nanofat treatment support skin regeneration.
- A correction of drooping eyelids can improve the quality of life.
- There is scientific evidence for the positive influence of upper eyelid lifting on personal self-esteem. However, this should not be the main reason for the operation.
- Drooping eyelid correction can be performed on an outpatient basis under local anaesthesia.
Excess skin can also be removed with a laser scalpel. The technology with the CO2 laser has no fact-based advantages over the conventional technology with the scalpel or the electrocautery. The high-energy laser beam of the laser burns the tissue. The energy of the carbon dioxide laser scalpel penetrating deeper into the tissue additionally leads to the obliteration of vessels. The cutting radius of a scalpel blade is more than 2,000 times smaller than that of a laser scalpel. Scalpel blades are usually made of stainless steel and have a cutting radius of five to a thousand nanometers. The scalpel cuts through the tissue selectively and protects surrounding structures.
CO2 laser treatment
Carbon dioxide lasers produce a high-energy light with a wavelength of 10,600 nanometers. The laser pulses are fractionally emitted at short intervals. Where the laser beam hits the skin, the skin cells evaporate. There is a slight burn on the skin surface. The repair mechanisms of the skin are accompanied by a slight shrinkage and smoothing of the skin. We would be happy to recommend you to a specialist in this field.
High-energy ultrasound waves heat the tissue a few millimetres below the epidermis. The changes in the tissue resemble a mild combustion. During the healing process, the tissue shrinks slightly. The use of ultrasound treatment is therefore limited to a minimal excess of skin. The effect lasts only a few years.
Different hyaluronic acids are available to compensate for tissue shrinkage. The differences lie essentially in the duration of action and the filling effect. Hyaluronic acid is a natural component of the connective tissue and is therefore well tolerated. Fillers can correct volume loss in the upper eyelid (hollowness). The effect lasts for twelve to eighteen months.
PRP (platelet-rich plasma) treatment can improve skin elasticity. Small skin wrinkles can be improved. However, PRP treatment is not the treatment of choice for a drooping eyelid.
Botulinum toxin is suitable for the treatment of dynamic wrinkles. In the eye area, crow's feet can be treated well with it. Forehead wrinkles and frown lines also respond well to Botox treatment. However, Botox should not be used on the upper eyelid. Botox can lead to paralysis of the eyelid lifters and under certain circumstances to a visual field restriction. The effect lasts for four to six months.
Treatment is associated with both opportunities and risks. Local anaesthesia, swelling or excessive scar healing can cause incomplete closure of the eyelid. Under conservative measures (head elevation, cooling, lymphatic drainage) the tissue tension usually decreases. 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. Injury to the lacrimal gland or a change in the closure of the eyelid can lead to a disturbance in the flow of tears or dry eyes. 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 considered for an upper eyelid lift with own fat:
- Value added tax of 19%.
- Remuneration for Plastic Surgery
- 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 may 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).
Privatdozent Dr. Stahl has studied eyelid correction with one of the world's leading plastic surgeons: Mark Codner, MD (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 a uniform photo documentation, but also the satisfaction with the eye contour, the upper lid crease and the stealing of your eyes. 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.