The lower eyelids have a very important aesthetic significance. Accordingly, discoloured dark circles, tear ducts or excess skin can give a tired impression. Excess skin or dark circles under the eyes can be caused by family history, age or lifestyle (e.g. smoking, stress or lack of sleep) and result from a progressive slackening of the connective tissue.
Dark circles under the eyes are the result of collagen deficiency, which causes the blood vessels under the skin to show through and dark circles to appear under the eyes. A lower eyelid lift can restore a fresh, alert and youthful appearance. The procedure is often combined with additional procedures to rejuvenate the eye area.
Lower eyelid lift: What are the techniques?
The incision for a lower eyelid lift can either be made from the outside in the area of the lower eyelid edge with corresponding skin and fatty tissue removal or in the area of the conjunctiva.
The advantage of an internal incision in the area of the conjunctiva is an invisible scar. However, the scar from an external incision will also become barely visible over time. In the case of pronounced “bags under the eyes” (actually fat pads), these can be redistributed through an internal incision and thus the tear trough can be corrected, as described in the diagram below. The so-called pull-through sutures are removed after 3 days.
For very severe skin sagging of the lower eyelid
In patients with very severe sagging of the lower eyelid, a so-called canthopexy is necessary, i.e. the outer edge of the eyelid is stabilised against the periosteum of the eye socket (so-called cat eye lift). In the course of a detailed consultation, it is individually determined which method is suitable for the patient.
From: Duan R., Wu M, Tremp M. et al, Aesthetic Plast Surg. 2019 Jun;43(3):680-685.
doi: 10.1007/s00266-019-01309-5. Epub 2019 Feb 7.
How is the operation performed?
The operation can be performed on an outpatient or inpatient basis. The operation can be performed under local anaesthesia, twilight sleep or general anaesthesia and is determined individually in the consultation according to the patient’s wishes and the extent of the operation.
What do I have to consider before the operation?
If you smoke, you must abstain from nicotine for two weeks before and after the operation. This improves the oxygen supply to the skin, accelerates wound healing and the scar heals more beautifully.
You should also not take blood-thinning painkillers such as Aspirin or Brufen or high doses of vitamin E for approx. 10 days before the operation. Therapeutic blood thinners such as Marcoumar®, Xarelto® or Eliquis® must be discontinued individually and after consultation with your doctor. Patients must refrain from using cosmetics and creams on the day of the operation.
Can a lower eyelid lift be combined with other operations and treatments?
A lower eyelid lift can be performed with a simultaneous midface lift. A lower eyelid lift is often combined with an autologous fat treatment (micro- or nanofat).
In addition to restoring facial volume, the advantage of a micro- and nanofat treatment is the simultaneous chemical reduction of skin pigment in the dark circles under the eyes using so-called fat stem cells. The lower eyelid lift can also be combined with other facial procedures (e.g. nose correction, upper eyelid lift, face and neck lift, eyebrow lift).
Are there alternative treatments for lower eyelid rejuvenation?
In the case of discreet excess skin, lower eyelid rejuvenation can be performed using a radiofrequency microneedling treatment. Other alternative options for non-surgical eyelid rejuvenation are laser treatments , chemical peels mesotherapy (hyaluronic acid, vitamins, amino acids, minerals and many other active ingredients, nanofat treatment or autologous blood treatment (so-called Platelet Rich Plasma = PRP.
The autologous blood treatment uses a growth cocktail (so-called growth factors/exosomes) of the blood platelets to rejuvenate the eye area by smoothing the wrinkles around the eyes and thickening the skin through collagen stimulation (biostimulation). This makes dark circles under the eyes less visible.
What are the risks of treatment?
As a rule, the risks of a lower eyelid lift are manageable and uncomplicated. Possible rare complications are haematomas, infections, secondary bleeding or drooping lower eyelid due to scarring or excessive skin removal. Eye injuries are also very rare, but cannot be completely ruled out.
Is a lower eyelid lift painful?
The lower eyelid lift is not very painful. Paracetamol is usually sufficient for the first few days after the operation. In addition, the eyelids should be cooled regularly.
Is the result permanent?
A first result is visible immediately after the operation, the swelling and redness will have subsided after approx. 10 – 14 days. The final result will then be visible after approx. 6-12 weeks.
What do I have to keep in mind after the operation?
The eyelid must be cooled immediately after the operation. This will prevent any swelling or bruising. To further reduce swelling, the upper body should be elevated for the first few days and also at night. Arnica can be taken for 7 days after the operation to reduce swelling.
Stitches are removed after 5 and 7 days. You are then generally socially acceptable and you can also apply make-up. Afterwards, I recommend regular scar care and sun protection SPF 50. If you wear lenses, you can wear them again after 2-3 weeks without any problems.
What are the costs?
As the procedure is often an aesthetic treatment, health insurance companies do not usually cover the applications. An exact cost estimate can only be provided after a personal consultation.