Eyelid lift (blepharoplasty)

Drooping eyelids | Bags under the eyesFrequently asked questions 

Many people have a tendency towards drooping eyelids at a young age. While the upper eyelids may be saggy or droop, the lower eyelids may be affected by puffiness or bags under the eyes. In the majority of cases these are typical symptom of old age. However, some people have a genetic predisposition that can manifest early on, giving the individual affected a tired and sad look. If the eyelids sag heavily the vision may also be affected. Drooping eyelids occur when the fat under the skin shrinks and the skin relaxes over it and hangs downwards. Bags under the eyes have a different cause. They are a result of fatty deposits extending from the eye socket and bulging forward because the supporting membrane is too weak. They are not caused by water retention or fatigue, as is often claimed.

Eyelid lift: Situation before surgery

Situation before surgery

Eyelid lift: Skin and fatty tissue (blue) are removed

Skin and fatty tissue (blue) are removed

Eyelid lift: Situation after surgery

Situation after surgery

In an upper lid lift, the incisions are placed in the natural crease of the upper eyelid. For lower lid lifts, the incision line is below the eyelashes and extends out to the side.

Upper eyelids | drooping eyelids

Drooping eyelids are a typical symptom of old age and are caused by the excess skin hanging downwards. The area of the eye beneath the eyebrows presses down on the lids as the elasticity of the skin declines, lending a tired and sad expression to those affected, (the “hangdog” look), and in the worst cases may even impair their vision. In surgery for drooping eyelids, the excess skin and fatty tissue are removed. The incision runs along the natural crease of the upper eyelid.

The Operation 

Surgery for drooping eyelids is performed in the Day Clinic of the Centre for Plastic Surgery and takes about an hour. You will leave the Day Clinic on the day of surgery, after staying for a short time.

Before the procedure our nursing staff and your specialist will prepare you for the operation ahead. This includes taking the “before” photos and marking the new lid contours on your skin. An eyelid lift is carried out under local anaesthetic or, on request, under general anaesthetic.

For an upper lid lift, an incision in the crease of your eyelid is made to remove excess skin and fatty tissue. The stitches will run along the natural crease of the upper eyelid and extend just beyond the corner of the eye.

Follow-up care 

The stitches will be removed three days after the eyelid lift (blepharoplasty). You will then wear small plasters over the incision sites for a further four days. Some temporary discoloration or swelling may occur. It takes about seven to ten days for everything to heal completely. Afterwards you will be able to resume normal eye care routines and apply make-up again.

We recommend taking things easy for a few days after the eyelid lift. Do not bend your head too far down or forward. Keep your head slightly elevated when sleeping. Apply sunscreen with a high protection factor and wear sunglasses when you go outdoors, to protect the scars from direct sunlight. In the winter months you should avoid exposure to extreme cold.

Lower eyelids | bags under the eyes

Bags under the eyes consist of fatty tissue and are not caused by water retention. The fatty deposits extend from the eye socket and tend to bulge forward when the supporting membrane is too weak. Bags under the eyes are considered particularly unsightly as they make a person appear unwell, puffy-eyed or older than their years. Drooping eyelids are generally associated with the aging process but also frequently appear in young people who are genetically predisposed to them.

In surgery for bags under the eyes, for patients with good skin elasticity we remove the fatty tissue via an incision below the eyelash line or inside on the conjunctiva.

The Operation 

Surgery for bags under the eyes is performed in the Day Clinic of the Centre for Plastic Surgery and takes about an hour. You will spend a few hours in our care after surgery. You will be able to leave the clinic on the same day.

Before the procedure our nursing staff and your specialist will prepare you for the procedure. We will take some pictures of your eye contour and draw in the future contours of the eyelid. An eyelid lift is carried out under local anaesthetic or, on request, under general anaesthetic.

In surgery for bags under the eyes, we remove the fatty tissue via an incision below the eyelash line or inside on the conjunctiva. If wrinkles and baggy skin are already present, an additional incision will be made to surgically remove the excess skin.

Follow-up care

The stitches will be removed three days after the procedure. You will then wear small plasters over the incision sites for a further four days. Some temporary discoloration or swelling may occur. It takes about seven to ten days for everything to heal completely. Afterwards you will be able to resume normal eye care routines and apply make-up again.

We recommend taking things easy for a few days after the eyelid lift. Do not bend your head too much and keep your head elevated when sleeping. Apply sunscreen with a high protection factor and wear sunglasses when you go outdoors, to protect the scars from direct sunlight. You should avoid extreme cold during the winter months.

Frequently asked questions about eyelid lifts

Will my eye shape change as a result of the eyelid lift?

No, your eye shape will not change. Only the excess skin and fatty tissue will be removed. An upper or lower eyelid lift does have an effect on your facial expressions as the eyes will have more «air» around them and be more prominent. Patients often report that people notice the difference and approach them after surgery with comments like: «Have you been on holiday? You look so relaxed and refreshed.»

Is an eyelid lift permanent?

The results of an upper lid lift last many years. The natural aging process will continue but the effects achieved by the eyelid lift will be lasting. If, over time and for reasons of predisposition, lifestyle, facial expressiveness or skin quality, your upper lids should start drooping again to the point where intervention is desired, the procedure may be repeated after a ten-year interval. On the other hand, removal of bags under the eyes is permanent, as all fatty deposits will be removed for good.

Will the scars be visible?

For an upper lid lift, the incisions will be placed so they are generally no longer visible once everything has healed. With a lower lid lift, the incision line is below the eyelashes and to the side, making it also barely visible.

Do I need to tell you about any medication I am taking?

It is extremely important in every case that you advise the specialist treating you of any illnesses and any medication you may be taking. For two weeks before the eyelid lift you must not take any medication containing aspirin (because of its blood-thinning effect). These medications may lead to excessive bleeding during the operation and delay the post-operative healing process. The specialist may decline to go ahead with the eyelid lift at any time if an increased risk is posed as a result of medication taken before the operation.

What are the risks associated with an eyelid lift?

As a general rule, any operation carries with it certain risks (e.g. intolerance of certain medication, bruising, delayed healing, inflammation, scar problems or loss of normal sensation). This all depends on the individual’s general state of health. Your specialist will discuss any potential risks with you as part of the consultation process and preparation for surgery.

In the case of lower lid lifts, one extremely rare complication is «ectropion» (a pulling away or turning outward of the lower lid). Inflammation may also occur at the corner of the eyelids in isolated cases. However, these are both temporary phenomena and can be treated.

When will I be able to socialise again?

This depends on how quickly you heal and how soon you wish to be seen, as well as your professional and social obligations. It takes seven to ten days for all traces of swelling and discoloration following surgery to completely fade. However, a few days after the stitches have been removed, any remaining discoloration may be gently concealed with make-up.

When will I be able to play sport again?

You should not play any sport for about four weeks after an eyelid lift.

How much does an upper or lower lid lift cost?

The cost of an eyelid lift depends on the type and scope of the surgical procedure involved and can only be determined through a private consultation and medical examination. In total you can expect to pay around 5,000 Swiss francs for an upper lid lift or about 6,000 to 8,000 Swiss francs for a lower lid lift. The preliminary consultation is 200 Swiss francs.

Are eyelid lifts covered by health insurance?

A lower lid lift is a purely aesthetic procedure – it is cosmetic surgery. The cost of a lower lid lift is therefore not covered by health insurance. In the case of severely drooping upper lids which, for instance, impair the patient’s vision, the costs are sometimes covered by insurance. However, partial cost cover by the health insurance company is rare and requires a thorough medical investigation.

Contact us for a consultation

Our doctors have many years of experience. We guarantee rapid, expert investigation and advice. Treatment is provided using the most up-to-date equipment and facilities. You are also welcome to ask us for a second opinion.

Facts and figures

Operation

Operation

About 1 hour, under local anaesthetic

Operation

In/outpatient

Outpatient

Post-operative treatment

Post-operative treatment

Plaster and stitches removed 3 days after surgery

Sport

Sport

Resume after 2 weeks

Ready to socialise

Ready to socialise

After 1 to 2 weeks

Costs

Costs

CHF 5,000 to CHF 8,000

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Centre for Plastic Surgery
Pyramid Clinic
Bellerivestrasse 34
CH-8034 Zurich

+41 44 388 14 14
+41 44 388 14 15

zpc@pyramide.ch
 

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