Upper Eyelid Lift & Hooded Eyelids

Which surgical methods and techniques does specialist plastic surgeon Dr Christian Metz use?

We perform upper eyelid surgery (blepharoplasty, from the Greek blepharon, meaning “eyelid”) as an outpatient procedure under local anaesthesia with sedation. Following the procedure and an appropriate recovery period, you can be driven home by someone accompanying you. During your pre-operative consultation, we will provide you with all the necessary information, including guidance for your recovery at home.

What exactly happens during the procedure?

On the day of surgery, following your pre-operative consultation, you will first receive the anaesthesia. The local anaesthetic is administered with a small injection into each eyelid, which is usually barely noticeable. The surgeon then carefully marks the skin to be removed.

A fine incision is made within the natural crease of the upper eyelid. Excess skin and fatty tissue are then removed. If necessary, the muscle surrounding the eye can also be adjusted. Finally, the incision is carefully closed using very fine sutures.

Do I need to stay in hospital for upper eyelid surgery?

Upper eyelid surgery is normally performed as an outpatient procedure under local anaesthesia, so an overnight hospital stay is not required. If the procedure is combined with more extensive surgery, or in certain medical circumstances, a hospital stay may be advisable. This will be discussed with you in advance during your consultation.

What type of anaesthesia is required for hooded eyelid surgery?

For upper eyelid surgery and the correction of hooded eyelids alone, the preferred approach is an outpatient procedure under local anaesthesia with sedation. During the procedure, you may notice a slight pulling sensation, but you should not experience pain. The sedative puts you into a relaxed, drowsy state while allowing you to remain responsive.

How should I prepare for the procedure?

Please inform us of any pre-existing medical conditions, allergies and medications that you take regularly. Ten days before surgery, medication containing acetylsalicylic acid (aspirin) and blood-thinning medication should be discontinued in consultation with your GP or prescribing physician.

You should also avoid nicotine and alcohol and refrain from taking sleeping medication. We recommend arranging some assistance at home during the initial recovery period, particularly with childcare, looking after pets and shopping.

What does the aftercare involve?

Swelling and bruising may occur during the first few days and can be reduced by cooling the area. These symptoms generally subside within a few days. On the day of surgery, you should keep your upper body elevated. Ideally, rest with your eyes closed and get plenty of sleep.

The sutures are removed after five to six days. Until then, makeup should not be applied, and ointments and creams should also be avoided. Heavy lifting and exercise should be avoided for three weeks. Direct exposure to sunlight should be minimised, and wearing sunglasses is recommended.

Lymphatic drainage of the lower eyelids may be beneficial in some cases. Dr Christian Metz will provide you with individual advice regarding scar care and when you can resume wearing contact lenses.

What are the risks associated with hooded eyelid surgery?

As with any surgical procedure, there are general risks. Post-operative bleeding can occur up to two days after surgery. If this happens, a doctor must be contacted immediately to minimise the risk of impaired vision and other complications.

Dr Metz will explain the potential risks of the procedure in detail during your pre-operative consultation.

What complications can occur?

You should contact your doctor if you experience severe pain, visual disturbances or significant swelling. Mild dryness of the eyes may occur after surgery and can usually be relieved with eye drops. Increased tear production may also occur during the first few days.

Temporary changes in sensation around the upper eyelids are also possible and generally resolve within a short period of time. Occasionally, small white bumps may develop on the upper eyelid; these can be removed by the surgeon if necessary.

Will I experience pain?

Immediately after upper eyelid surgery, you may experience a feeling of pressure or tightness around the eyelids. This is generally mild and usually subsides quickly. Pain-relieving and anti-inflammatory medication, such as ibuprofen, as well as cooling packs may help alleviate discomfort.

Will there be visible scars?

The incision is usually positioned precisely within the natural upper eyelid crease. With normal scar healing, the resulting scar generally becomes barely noticeable over time. At the outer edge of the eyelid, only a fine incision line remains.

When can I return to work after upper eyelid surgery?

Depending on the nature of your work, you can usually return after two to seven days. If your job involves strenuous physical activity, you may need to wait longer to ensure that increased blood flow does not interfere with wound healing. We will discuss the appropriate recovery period with you during your consultation.

When can I resume social activities?

Depending on the healing process and your individual preferences, most patients feel comfortable resuming social activities after approximately eight days. Any remaining redness can generally be concealed effectively with makeup.

Are there alternatives to surgery?

If there is a significant amount of excess skin on the upper eyelid, there is unfortunately no non-surgical alternative that can achieve the same correction.

How much does the procedure cost?

Following your consultation, we will be pleased to provide you with an individual cost estimate. Upper eyelid surgery starts from approximately €2,100.

When is the procedure covered by health insurance?

Upper eyelid surgery generally has to be paid for privately. In rare cases, where a drooping upper eyelid significantly restricts the field of vision, health insurance may cover the cost of the procedure, subject to the individual insurer's requirements and approval.

Can upper eyelid surgery be repeated if necessary?

A second procedure is not normally necessary. However, if after several years you feel that your upper eyelids would benefit from further correction, another procedure may be possible.

The outcome of the initial surgery must first be allowed to develop fully. A final assessment is generally possible after approximately six months, once the healing process is complete.

Can upper eyelid surgery be combined with lower eyelid surgery?

Yes, upper and lower eyelid surgery can be performed together in selected cases. Patients with under-eye bags often wish to have these corrected at the same time.

When both procedures are combined, the operation takes somewhat longer, and post-operative swelling and bruising may be slightly more pronounced.