The appearance of the eyes is decisive for the impression we make on others. The eyelash line, the natural eyelid crease and the eyebrows interact harmoniously. Below the natural eyelid crease is the movable eyelid, above it is the outer eyelid. The outer eyelid has a harmonious, slightly outward curved contour. The most important beauty feature is a balanced height ratio between the movable eyelid and the outer eyelid. In the case of a drooping eyelid, the sagging skin covers the entire movable eyelid. The eyelid skin rests on the eyelashes and the upper eyelid feels heavy. The brightness of the eyes is lost. The eyes become smaller. Fat loss on the outer upper eyelid leads to an inward bulge and a shadow above the inner eyelid crease. This change is called "A-frame deformity" in English. The so-called "A-frame deformity" makes you look more tired and older than you are. Seemingly small changes play an important role in the first impression.
In the course of life and with increasing age, the elasticity of the skin and muscles of the eyelids decreases. If there is a familial predisposition, these changes can also occur before the age of forty. When the skin of the upper eyelid sags, so-called drooping eyelids form. Many patients decide to have an eyelid lift for aesthetic reasons and wish to have a lower eyelid lift in combination. In some cases, however, patients also complain of heavy eyelids or even impairment of the field of vision. In these cases, it is not just a desire for cosmetic surgery, but a medically necessary surgical procedure to improve a patient's daily life. Surgery costs are covered by health insurance for this minor procedure with a major effect.
During an upper eyelid correction (also called drooping eyelid surgery), the patient has a strip of skin and muscle removed by a specialized and experienced specialist. In the course of this method, fat pads are redistributed and a balanced contour of the outer eyelid can be achieved by using nanofat. The later scar of a drooping eyelid surgery can be hidden in the fold of the eyelid and is therefore not visible. The eyelid correction opens the eye and helps to achieve a "fresher" appearance. In addition, in the before and after comparison, a disappearance of the tired appearance is noticeable due to the plastic-aesthetic intervention. When looking in the mirror, the patient notices the now wider open eyes.
The safety of our patients comes first. For your safety, at the surgery appointment, several experts (the surgeon, the assistant and the surgical specialist) check all parameters several times before the surgical procedure. The drooping eyelid correction does not begin until the safety checklist has been completely and correctly filled out.
A light twilight sleep takes away your fear of the eyelid lift and reduces your sensitivity to pain. Before the eyelid surgery, the surgeon marks the planned incision and checks each step of the eyelid lift for the purpose of removing hanging parts of the eyelid and tightening the eyelid. For maximum precision and optimal results, the plastic surgeon operates with magnifying glasses. The local anesthetic is injected into the eyelid. Within five to ten minutes, the surgical area is numb and the drooping eyelid surgery can begin. If you are not already deeply asleep, you will at most feel something happening on the eyelids thanks to the local anesthetic. The adrenaline contained in the anesthetic prevents bruising. To remove the drooping upper eyelids, the excess skin and muscle is gently removed with a scalpel. Sensitive handling of the tissue keeps swelling to a minimum. According to the patient's needs, excess fatty tissue is redistributed or nanofat is grafted into the upper eyelid. Depending on the initial findings, the eyebrow can be lifted. To soften the frown line, a small muscle can be removed in the area of the inner corner of the eyelid (Musculus corrugator supercilii). Different procedures can be combined to achieve an optimal aesthetic result. Finally, the edges of the wound are sutured. Local anesthesia lasts beyond the eyelid lift procedure. The total surgery time for upper eyelid lift of both eyes is about 45 minutes. You will receive a small bandage. It is important to cool the eyes after the eyelid lift.
Immediately after the eyelid lift, you will be continuously monitored in a so-called recovery room. You will be able to drink something after fully awakening and, if you tolerate it well, you will also be able to eat something. Before you leave the surgery, appointments to check the results of the surgery will be made with the expert and the behavioral measures will be discussed with you in detail. You will be given a report and a telephone number. The treating expert of aesthetic surgery is available for you 24 hours a day after the eyelid lift.
- All your questions about possible complications, risks and alternative treatments should be answered before the eyelid surgery.
- Limit nicotine and alcohol consumption to a minimum before eyelid surgery.
- Blood-thinning medications (for example, ASS, Thomapyrin®) must be discontinued for medical reasons ten days prior to plastic surgery after consultation with your attending physician.
- The intake of hormone-containing medications (the pill) must be temporarily discontinued in the run-up to the eyelid lift.
- Discontinue vitamin preparations (A, E) and dietary supplements (for example omega-3 fatty acids, St. John's wort preparations) four weeks before the eyelid lift.
- Have cooling pads or cooling glasses ready at home to cool the skin after the procedure.
- You will be sensitive to the sun during the first period after the eyelid lift. Therefore, bring dark sunglasses with you to the surgery. Of course, they also hide the inevitable postoperative swelling and bruises.
- Aesthetic plastic surgery, such as eyelid lifting, restricts your ability to travel by air. Do not plan any air travel for business or pleasure in the four weeks following the drooping eyelid surgery.
- Take out follow-up cost insurance before the upper eyelid lift.
- After the drooping eyelid surgery you are not allowed to drive until you have regained your unrestricted vision. On the day of the surgery appointment, driving is to be strictly avoided simply because of the accompanying medication.
- Your well-being and the result of the eyelid lift will be checked regularly.
- Plenty of rest and cooling of the eye will help to keep swelling down during the first three days after the aesthetic correction. Use light cooling pads or cooling glasses.
- Adherence to the rules of hygiene greatly ensures the result of the eyelid lift. Hands should be washed regularly with liquid soap for a period of 30 seconds. Avoid contact with animals.
- Upper body elevation of about 30 degrees (even while sleeping) for five days is beneficial for decongestion, decrease of bruises and for wound healing.
- Swelling may prevent you from closing your eyes completely the first day. Use eye drops or gel for a week to keep the conjunctiva from drying out.
- On the fifth postoperative day, skin sutures will be pulled. For optimal healing, avoid eye makeup for the first week after eyelid lift surgery. Do not apply makeup over the scar during the first week.
- Refrain from wearing contact lenses for the first week. Avoid reading, watching television or working at the computer, as this reduces the blinking of the eyelashes and thus the still somewhat irritated conjunctiva is less moistened.
- After about one, better two weeks after the eyelid lift you can go back to work. By then the swelling and the roughest effusions will have disappeared.
- From the third post-operative week onwards, several daily massages for a few minutes in circles, as well as lengthwise and crosswise to the course of the scar with greasing creams (for example Bepanthen® ointment or Linola® fat) will help to make the scars inconspicuous.
- Avoid bending over, lifting heavy loads, swimming, saunas, and sports activities during the three weeks after eyelid lifting. If swelling is still present, prolonged rest may be advisable.
- Excessive UV exposure (solarium/sunbathing) should be avoided for at least three months after eyelid surgery.
- Smoking prevents the grafted fat cells from healing and increases the risk of inflammation and thrombosis. Avoid tobacco smoking and e-cigarettes for the six weeks following eyelid lift surgery.
Lifting of the upper eyelids is one of the most common aesthetic plastic surgery procedures for patients between the ages of forty and sixty. You will benefit from eyelid lifting if you suffer from a tired facial expression due to excess skin (drooping eyelids). If you have undergone laser treatment to correct a vision defect in the last six months, you should refrain from eyelid lift surgery. Surgery for droopy eyelids may exacerbate pre-existing dryness of the eyes. If you suffer from dry eyes, caution is advised.
Eye circles, drooping eyebrows, crow's feet, weakness of the eyelid elevator muscles, drooping tear ducts, or bulging fatty tissue will equally affect your appearance. The surgeon will show you the treatment options for these changes during an individual consultation.
For an optimal, aesthetic and natural result, your change requests are first asked. With an excess of skin, the look can appear tired, stern or evil. In order to estimate the extent of the correction, it is very important to know if you have had any recent treatment with muscle relaxants. In order to plan the follow-up treatment, it is asked whether you suffer from defective vision, wear glasses or contact lenses.
To identify and prevent possible risks in time, Dr. Santos Stahl will ask for information about the following:
- High blood pressure,
- Coagulation disorders,
- Pre-existing conditions, such as thyroid disease, glaucoma,
- Previous operations, especially eye operations
- Allergies and
- Taking medication.
Please let us know if you smoke or take any dietary supplements. These factors have a great influence on your eyelid lift. In addition, during the individual consultation, common questions will be clarified and you will receive further information.
The skin, the eyelid fissure, the symmetry, the position of the eyebrows, the position of the eye and the elasticity of the eyelid will be closely examined. The strength of the eyelid elevator is measured. After a complete and thorough physical examination, cosmetic surgery specialist Dr. Santos Stahl will discuss with you whether, beyond the removal of excess skin, the removal or repositioning of fatty tissue may be an option. She will show you various alternatives to drooping eyelid surgery and the associated risks and limitations. Circles under the eyes, drooping eyebrows, crow's feet, frown lines, weakness of the eyelid lift muscles, drooping tear ducts or bulging fatty tissue all affect the appearance. For a harmonious overall result, each change should be treated specifically. During the consultation you will receive all the information so that you can decide which treatment is right for you. It is very important to discuss your expectations openly with the expert. Often a poor exchange of information between the treating specialist and the patient is the cause of an unsatisfactory result, even if there are no complications with the eyelid lift.
Dr. Santos Stahl discusses all details of the procedure with you, including the type of anesthesia used, follow-up insurance, preparatory measures and behavioral measures after the procedure. She will lay out the cost of the upper eyelid lift procedure in a transparent and understandable manner.
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 up afterward. At the end of the initial consultation, we are happy to offer you a second consultation. It is very important to us that all your questions have been answered before the eyelid lift.
If you suffer from dryness of the eyes, at best a so-called Schirmer test should be carried out by an ophthalmologist beforehand.
- An upper eyelid lift can leave you looking "rested" and "fresher."
- The scar from a droopy eyelid surgery is usually barely noticeable in the crease of the eyelid.
- If you suffer from pronounced drooping eyelids, your visual field may improve after an upper eyelid lift.
- Many patients raise their eyebrows to counteract drooping eyelids. Constant tension on the muscles of the forehead can lead to headaches, which can be eliminated with an upper eyelid lift.
- The stem cells of a nanofat treatment support skin regeneration.
- Correction of drooping eyelids can improve the quality of life.
- There is scientific evidence for the positive impact of an upper eyelid lift on personal self-esteem. Nevertheless, this should not be the decisive reason for eyelid lifting.
- A drooping eyelid surgery can be performed on an outpatient basis and under local anesthesia.
Excess skin can also be removed with a laser scalpel. Fact-based advantages of the technique with the CO2 laser compared to the conventional technique with the scalpel or the electrocautery, respectively, do not exist. The high-energy laser beam of the laser causes burning of 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 over 2,000 times smaller than that of a laser scalpel. Scalpel blades are typically made of stainless steel and have a cutting radius of five to one thousand nanometers. The scalpel cuts through tissue selectively and spares surrounding structures.
CO2 laser treatment
Carbon dioxide lasers produce a high-energy light with a wavelength of 10,600 nanometers. The laser pulses are emitted fractionally in short intervals. Where the laser beam hits the skin, vaporization of the skin cells occurs. This results in a slight burn on the surface of the skin. The repair mechanisms of the skin are accompanied by a slight shrinking and smoothing of the skin. We will be happy to refer you to a specialist in this field.
High-energy ultrasound waves heat the tissue a few millimeters below the epidermis. The changes in the tissue resemble a mild burn. In the course of the healing process, a slight tissue shrinkage occurs. The application of ultrasound treatment is therefore limited to a minimal excess of skin. The effect lasts only a few years.
Various hyaluronic acids are available to compensate for tissue shrinkage. The differences are mainly in the duration of action and the filling effect. Hyaluronic acid is a natural component of connective tissue and is therefore well tolerated. Fillers can correct a loss of volume in the upper eyelid (in English "hollowness"). The effect lasts twelve to eighteen months.
Autologous blood therapy
An autohemotherapy treatment can improve skin elasticity. Small skin wrinkles can be improved with it. However, for a drooping eyelid, an autologous blood treatment is not the treatment of first choice.
Muscle relaxants are 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 muscle relaxant treatment. However, muscle relaxant should not be used in the upper eyelid area. It can lead to paralysis of the eyelid elevators and, under certain circumstances, to a reduction in the field of vision. The effect lasts four to six months. Therefore, be sure to select a specialized practitioner for treatment.
Treatment is associated with opportunities but also with risks. The local anesthesia, swelling or excessive scar healing can cause incomplete eyelid closure. Under conservative measures (elevation of the head, cooling, lymphatic drainage) the tissue traction usually subsides. Tissue irritation during eyelid lifting or disinfection may cause swelling of the connective tissue. Rest and cooling usually cause the swelling to subside. Accompanying medical treatment may be necessary. Irritation of the cornea by disinfectant may cause temporary visual blurring. In the unlikely and very rare event of hemorrhage behind the eyeball in the first few hours, the optic nerve must be immediately relieved surgically. Scar healing takes six to twelve months. Usually, after one year, scars are pale, soft, painless and flat. Side differences, which exist in every person, can also cause slightly different scarring or skin wrinkles after eyelid lifting. Injury to the lacrimal gland or a change in the closure of the eyelid can cause a disturbance in the flow of tears or dryness of the eye. Eyelid lift is one of the five most common aesthetic surgical procedures performed worldwide. Compared to the most common aesthetic plastic surgeries, eyelid lift is one of the plastic aesthetic surgical procedures with the lowest risks.
The following remuneration components must be considered for an eyelid lift of the upper eyelid with autologous fat:
- Value added tax
- Remuneration of the plastic surgery procedure
- Nursing services required in the course of the treatment
- Consumables required during the eyelid lifting procedure
- Follow-up insurance
- Wound control after eyelid lifting surgery
- Long-term controls after the surgery of the eyelids
- Permanent availability of the surgeon during the two weeks after the eyelid lift surgery
Many patients compare different offers before an eyelid lift. For a direct comparison, all expenses including aftercare must be considered. A doctor's training, experience, skills and science competencies are more difficult for a layperson to compare than cost. Inquire about the qualifications of the doctor you are trusting. The terms "cosmetic surgeon," "aesthetic surgeon" or "cosmetic surgeon" are not trademarked. This is different for the professional title "plastic and aesthetic surgeon", these doctors have all completed a corresponding six-year training. This is similar for ear, nose and throat specialists and oral and maxillofacial surgeons, these specialists can acquire the additional qualification "plastic surgery" after two years of further training and are thus qualified for interventions in the area of the head. 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 activity. Professional experience in a managerial role strengthens the sense of responsibility and the competence to solve complex and difficult challenges. Treatment costs are relevant to decision-making, but trust in the physician should ultimately be decisive.
On our cost page, we provide information on guideline values for the cost of surgery. Unfortunately, it is not possible to give an exact price without an examination, since, among other things, the scope of treatment and any previous illnesses and/or pre-treatments cannot be taken into account. After an examination during a personal consultation, we will provide you with an individual offer. We will also be happy to advise you on financing options without obligation.
Your health insurance will pay for an upper eyelid lift if the procedure is medically necessary. If an ophthalmologist determines and certifies a limitation of the visual field, you can apply for coverage by the health insurance. An eyelid lift paid for by health insurance is performed to restore the visual field. Cosmetic surgery of the upper eyelid improves the appearance. Although both procedures are called "upper eyelid lift," the goals and therefore results, surgical techniques and expense differ. A medically indicated drooping eyelid surgery excludes a cosmetic surgery (aesthetic surgery without medical indication). Therefore, cosmetic surgery must be performed independently of medically indicated surgery. You can find more information on our page about the obligation of health insurance companies to pay benefits.
The comparative pictorial representation of the treatment success by before/after photographs may not be published on the Internet according to § 1 Paragraph 1 No. 2 of the Therapeutic Products Advertising Act. Nevertheless, before/after pictures of eyelid lifts can be used in patient education. We will be happy to show you before and after pictures during a personal consultation in order to show you the possibilities and limitations of cosmetic surgery and especially of eyelid lifting. Of course, we adhere to all legal regulations regarding data protection. You can find more information on our before and after pictures page.
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 representatives of aesthetic and plastic surgery. Afterwards, Dr. Santos Stahl obtained the German as well as the European specialist qualification. She specialized 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 representatives of aesthetic surgery in Dallas, Oakland and Salt Lake City - thanks to a scholarship from the largest professional society of plastic surgeons in Germany (VDÄPC).
PD Dr. Stahl trained with one of the world's leading plastic surgeons in the field of eyelid correction, Mark Codner, MD (www.markcodnermd.com). PD Dr. Stahl became a senior consultant and permanent deputy to the medical director at the University Hospital of Tübingen in 2015. From 2016 to 2018, he moved to Lüdenscheid as clinic director. PD Dr. Stahl has continued to refine his microsurgical techniques over the years, so that today he enjoys a reputation among experts as a particularly gentle and precise surgeon. Various fellowships have taken him to outstanding cosmetic surgeons in Brazil, New York, Atlanta and Salt Lake City.
Medical decisions and recommendations must be based on proven effectiveness. In order to assess the validity of scientific evidence, a physician's scientific skills are important. For this purpose, an additional qualification as an investigator and experience in the conduct of clinical trials is an advantage. These requirements apply to Dr. Santos Stahl and PD Dr. Stahl.
With our extensive experience in the field of aesthetic surgery, we systematically examine and compare the appearance, well-being and satisfaction of our patients after an eyelid lift. This includes not only consistent photo documentation to record the visible results, but also satisfaction with the eye contour, upper eyelid crease and the radiance of your eyes. Nevertheless, we also systematically review a possible impact of the procedure on perceived self-confidence and attractiveness. We encourage our patients to rate us on Jameda and Google. Many are willing to share their experience with other sufferers to help you make the right decision. We are happy to put you in touch with these patients during your personal consultation. In addition, you can find patient testimonials and reviews on our Testimonials page.