Eyelid surgery Stuttgart

The skin around the eyes is the thinnest and most sensitive on the entire body, which is why the first signs of aging often appear here earlier than elsewhere. Over the years, the tissue loses elasticity and firmness, the muscles slacken and the fine fat pads that naturally surround the eye shift. On the upper eyelid, this often results in excess skin known as a hooded eyelid, which makes the look appear tired and heavy, while under-eye bags and fine lines can form on the lower eyelid. In addition to the natural aging process, hereditary predisposition, individual lifestyle and external influences also play a role. The most common reasons why my patients decide on eyelid surgery are:

• Sagging upper eyelids and hooded eyelids: Excess skin on the upper eyelid, sometimes resting on the lashes, that makes the look appear tired and sad.
• Under-eye bags and swelling on the lower eyelid: Protruding fat pads and swelling under the eyes that persist even after sufficient sleep and make the face look exhausted.
• A tired or sad facial expression: Many patients report that people around them regularly comment on a weary or dissatisfied expression that does not reflect how they actually feel at all.
• Restricted field of vision: With very pronounced hooded eyelids, the excess skin can restrict the upper field of vision, so the correction has not only aesthetic but also functional reasons.
• Fine lines and sagging eyelid skin: Overall sagging and crinkly eyelid skin that deprives the eye of its fresh, alert frame.

As individual as the extent is, the motives are just as varied. For some, the desire for a fresher appearance is the priority; for others, the functional improvement of the field of vision. In both cases, carefully planned eyelid surgery can open up the eye again and restore an alert and open expression to the face.

Before deciding on the right method, it is worth taking a close look at the various changes that can occur on the eyelids over time, because only a precise understanding of the findings leads to the right treatment. The following forms are the most common initial situations in my practice; they can also occur together and can then be treated in one session.

A hooded eyelid occurs when excess skin forms on the upper eyelid and lies over the lid margin as a fold of skin, in pronounced cases even reaching the lashes. Technically, this age-related excess skin on the upper eyelid is referred to as dermatochalasis. It makes the look appear tired, heavy and older than you actually feel, and in very pronounced cases the drooping upper eyelid can even restrict the field of vision. In addition to the natural aging process, hereditary predisposition often plays a role here, so hooded eyelids can certainly occur at a younger age. This finding is treated with an upper eyelid lift, in which the excess skin and, if necessary, some muscle and fatty tissue are removed.

Under-eye bags are the protruding fat pads and swelling that appear below the eyes and give the face an exhausted expression. They are caused by a bulging of the natural fat pads that surround the eye and shift forward over time. Characteristically, this swelling persists even after sufficient sleep, because its cause lies not in tiredness but in this shift of the fatty tissue. Under-eye bags are treated as part of a lower eyelid lift, in which the excess fatty tissue is reduced or, where appropriate, repositioned into deeper areas.

As the skin loses its firmness, fine lines and overall crinkly, sagging eyelid skin develop on both the lower and upper eyelids, depriving the eye of its fresh frame. Depending on the extent, this finding can be corrected as part of eyelid surgery by targeted tightening of the skin; in milder cases, skin-smoothing procedures can also be considered, and I will advise you on this individually.

An eyebrow that has drooped over the years presses the upper eyelid down and thus reinforces the impression of a hooded eyelid, without itself being pure excess skin. This distinction is crucial, because a drooping brow cannot be corrected by an upper eyelid lift alone but may require a targeted lift of the brow. I explain why this precise distinction is so important in the following section.

In addition to these common forms, there are some more specific eyelid findings that require particularly careful assessment. Ptosis refers to an upper eyelid that droops not because of excess skin but because of a weakness of the eyelid-lifting muscle, which requires a different surgical approach than a classic upper eyelid lift. So-called double eyelids, which occur mainly in people of Asian descent and are characterized by a particular fold structure of the upper eyelid, can be treated with special eyelid surgery techniques. Finally, malpositions of the eyelid margin, in which the eyelid is turned inwards (entropion) or outwards (ectropion), are medical findings that can lead to irritation and discomfort and require targeted functional correction. Which of these findings applies to you and which treatment is actually the right one can only be reliably assessed after a personal examination, which is why a careful and individual analysis of your eye area always comes first.

This question is particularly important to me, because the answer determines whether the result is good and natural, and because it is asked too rarely in many consultations. Not every drooping upper eyelid is actually a case for a classic upper eyelid lift, because a heavy, tired look can have various causes that look similar from the outside but must be treated completely differently. This is exactly where my careful diagnostics come in, because only those who recognize the real cause can choose the right treatment.

Behind a supposed hooded eyelid, for example, there may in fact be an eyebrow that has drooped over the years, pressing the upper eyelid down. In such a case, an upper eyelid lift alone would not solve the problem at its root, whereas a targeted lift of the brow, for example by means of a direct brow lift, is the more natural and sustainable approach. Likewise, a drooping upper eyelid can be due to a weakness of the eyelid-lifting muscle, so-called ptosis, which requires a different surgical correction than pure excess skin. For this reason, before every eyelid lift I carefully examine the entire eye and brow region and how its parts interact, so that together we choose the method that is actually right for your individual findings. This honest advice, which in case of doubt may also advise against a procedure or recommend a different treatment, is for me the basis of all successful eyelid surgery.

A procedure on the eyelids requires a particularly fine touch, because even the smallest deviations in the sensitive eye area can change the overall appearance of the face. My aim is therefore to operate as much as necessary and as little as necessary, because with eyelid surgery in particular, less is often more. My goal is never a changed face but always a fresher and more alert one that looks like you, in which people do not notice the operation but only the rested result.

Compared to a large clinic, I offer you personal care from a single specialist who advises you, operates on you himself and supports you for more than a year after the procedure. You can rely on my more than 16 years of experience and more than 6,400 aesthetic procedures performed just as much as on my consistent focus on gentle surgical procedures that protect the sensitive tissue around the eye as well as possible and enable healing with few complications. Because the upper eyelid lift can usually be performed on an outpatient basis under local anesthesia, the procedure remains as gentle and uncomplicated as possible for you.

For me, every eyelid lift begins with a detailed, personal consultation in which I first get a comprehensive picture of your wishes, your expectations and your medical history. I then carefully examine your eye area, assessing the excess skin, the condition of the eyelid skin, the position of the eyebrows and the function of the eyelid muscles, in order to determine whether an upper eyelid lift, a lower eyelid lift, a combination of both procedures or possibly another approach makes sense for you.

On this basis, I work out an individual treatment concept together with you and explain openly what can realistically be achieved in your case. You will receive an honest assessment, transparent information about the procedure, aftercare and costs, and plenty of room for all your questions. Precisely because the relationship of trust between patient and doctor is particularly important for a facial procedure, I deliberately take a lot of time for this consultation.

The upper eyelid lift is the most common procedure in eyelid surgery and at the same time one of the most rewarding, because a comparatively small procedure can achieve a great and at the same time natural effect. The aim of the operation is to remove the excess skin on the upper eyelid that lies over the lid margin as a hooded eyelid, thus restoring the eye's open, alert frame. If necessary, protruding fat pads are also reduced or repositioned to achieve a smooth and harmonious result.

I usually perform the upper eyelid lift on an outpatient basis under local anesthesia, so that you are awake but completely pain-free during the procedure, which takes around an hour, and can leave the practice afterwards accompanied by someone. I deliberately place the necessary skin incision in the natural eyelid crease of the upper eyelid, because that is exactly where the subsequent scar is hidden when the eye is open, and it is barely noticeable after complete healing. After removing the excess tissue, I close the incision with a particularly fine suture, whose stitches are removed after about a week. The result is a visibly more open, fresh eye with a scar that blends discreetly into the natural eyelid crease.

As already described, a drooping upper eyelid is not always due to excess skin alone, but sometimes to a drooping eyebrow pressing the eyelid down. In such cases, it can make sense to combine the upper eyelid lift with a targeted lift of the brow, a so-called direct brow lift, because only the interplay of both measures leads to a truly harmonious and lasting result. Whether such a combination is an option for you is something I assess as part of the careful analysis of your eye and brow region in the consultation.

The lower eyelid lift is aimed at patients who are bothered by protruding under-eye bags, swelling or sagging, finely lined skin below the eyes. As exactly these changes quickly make a face look exhausted and older, a carefully performed lower eyelid lift can restore much of the face's freshness. The procedure on the lower eyelid is technically more demanding than the upper eyelid lift, because the lower eyelid is more sensitive and requires a particularly careful approach so that the natural shape of the eye is fully preserved.

There are basically two different approaches to the lower eyelid lift, which I choose depending on the findings. In the transcutaneous technique, the fine skin incision runs directly below the lash line, so that the subsequent scar is almost invisibly hidden there. This method is particularly suitable when excess skin is to be tightened in addition to excess fatty tissue. If, on the other hand, there is primarily excess fat without significant excess skin, the transconjunctival technique can be considered, in which access is gained through the inside of the lower eyelid and no visible scar remains on the outside at all. In the case of pronounced laxity of the lower eyelid, it may also make sense to specifically tighten and lift the outer corner of the eye by means of a so-called canthopexy, so that the eyelid permanently retains its natural tension and shape. I decide which approach is right in your case together with you after a thorough examination.

As part of the lower eyelid lift, the protruding fat pads that appear as under-eye bags can be specifically reduced or repositioned into deeper areas, so that the transition between lower eyelid and cheek appears soft and harmonious again. Repositioning the fatty tissue rather than simply removing it has proven particularly effective, because it also fills a sunken tear trough and the resulting dark shadows, giving the eye a much more rested expression. Dark circles under the eyes, which are often caused by sunken areas and shadowing, can be reduced in this way. In some cases, complementary treatment may make sense, such as filling sunken areas with hyaluronic acid, on which I will advise you individually if required. My goal is always a rested and natural result that preserves the alert character of your gaze.

Good preparation contributes significantly to a course with few complications and a beautiful result. I discuss the most important points you should consider before eyelid surgery with you in detail in the consultation; at a glance, they are:

• Avoiding blood thinners: Certain medications and preparations such as acetylsalicylic acid can increase the tendency to bleed and should be paused in good time before the procedure in consultation with me.
• Avoiding nicotine: Nicotine impairs blood circulation and wound healing, which is why abstaining before and after the operation safeguards the result.
• Well-controlled pre-existing conditions: Existing conditions such as high blood pressure should be well controlled before the procedure. Certain eye conditions should be clarified in advance.
• Organization for the day of surgery: As vision may be temporarily restricted after the procedure due to dressings and swelling, you should arrange for someone to accompany you home and plan for some support in the first few days.
• Realistic expectations: An open conversation about what can be achieved is the best basis for your satisfaction with the result.

You will receive all further individual instructions, for example on medications to take or pause, from my practice in good time and in writing, so that you are well prepared for the procedure.

On the day of the operation, I first carefully mark the planned incision on your eyelids while you are sitting upright, because only then can the actual excess skin be assessed precisely. The surgical area is then locally anesthetized, so that you are awake but completely pain-free during the procedure. On request and for more extensive combined procedures, local anesthesia can be supplemented with light twilight sedation, or in exceptional cases general anesthesia can be chosen, which we discuss together in advance.

In an upper eyelid lift, I remove the excess strip of skin along the natural eyelid crease and reduce protruding fatty tissue if necessary; in a lower eyelid lift, access is gained, depending on the findings, via a fine incision below the lashes or through the inside of the eyelid. In both cases, I work with the greatest precision and care to protect the sensitive tissue and achieve a natural result. Finally, I close the incisions with very fine sutures and dress the eyelids, so that you can leave the practice accompanied by someone after a short rest. Depending on the extent, the procedure usually takes about one hour.

Careful aftercare is of great importance after eyelid surgery, which is why I follow up with you closely for a period of at least one year and am available for all your questions and concerns. In the first few days after the procedure, swelling and bruising in the eyelid area are completely normal and usually subside significantly within one to two weeks. Consistently cooling the eye area in the first few days counteracts swelling and is perceived by most patients as very pleasant. I recommend sleeping with your upper body slightly raised during this time and taking it easy physically.

I remove the fine stitches after about a week; small wound dressings remain for around ten days depending on the course of healing. Once the stitches have been removed and the initial swelling has subsided, most of my patients are able to go out in public again, which is usually the case after about seven to ten days. With light office work, it is often possible to return to work after about one week; for physically strenuous work, a somewhat longer break is advisable. In the first few weeks, you should consistently protect the fresh scars from sunlight and support them with suitable care after healing so that they heal as inconspicuously as possible.

You should refrain from sports and physically strenuous activities for about two weeks and then slowly increase the strain again; I also advise against saunas, intense sun and wearing contact lenses in the first few weeks until the eyelids have completely healed. A first beautiful result is usually visible after just a few weeks; the final and completely natural result unfolds once the last slight swelling has subsided and the scars have completely faded. Throughout this time, I am at your side as a companion who, just like you, strives for the best possible result.

Eyelid surgery is an established procedure with very few complications when performed professionally; nevertheless, like any operation, it involves certain risks, which I will explain to you openly and fully before the procedure.

• Swelling and bruising: In the first one to two weeks, swelling and bruising in the eyelid area are normal and usually subside on their own.
• Feeling of dryness and a foreign body: A feeling of dryness, tightness or a slight foreign-body sensation in the eyes may occur temporarily, usually returning to normal within a few weeks.
• Temporarily restricted eyelid closure: In rare cases, complete closure of the eyelid may be temporarily difficult, which usually resolves during healing.
• Noticeable scarring: Even though the incisions are deliberately hidden in natural folds, more noticeable scarring can occur in rare cases and with a corresponding predisposition.
• Small asymmetries: Slight differences between the two sides are possible and can be evened out with a small correction if necessary.
• Secondary bleeding and infections: As with any procedure, secondary bleeding or infections are possible in principle, but very rare thanks to careful technique and high hygiene standards.

Through my many years of experience, a particularly gentle and precise approach and close aftercare, I keep these risks as low as possible. I discuss all aspects relevant to you in detail in the personal informational consultation, so that you can make your decision on a well-founded basis.

The cost of eyelid surgery depends on the extent of the procedure and your individual findings, in particular whether only the upper eyelid, only the lower eyelid or both areas are treated and whether the procedure is combined with another measure such as a brow lift. In my practice, an upper eyelid lift starts at around €2,900; I will tell you the exact costs for your case transparently during the personal consultation.

This fee includes surgical planning, the procedure itself, the necessary materials and complete preparation and aftercare over one year. If local anesthesia with twilight sedation or general anesthesia is required for a more extensive combined procedure, the costs of anesthesia are shown separately and transparently. You will receive a complete, written cost plan from me in advance, so there are no hidden items for you. In certain cases, for example if a very pronounced hooded eyelid demonstrably restricts the field of vision, partial cost coverage by health insurance may be considered under certain circumstances, which must be checked in the individual case.

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