Plastic surgery of the lower eyelid

Eyes are an important component of the overall aesthetic perception of the face, and they play a key role in perceiving its overall harmony. That’s why plastic surgery of the  eyelids has become one of the most frequently performed facial cosmetic surgeries. 

The human eye is contained within the orbital cavity, surrounded by a fat pocket bordered by a fine connective sheath. This sheath loses its rigidity over time, and the fat pockets gradually push into the subcutaneous tissue of the eyelid. This results in a so-called fat prolapse, and so eye bags are formed.  This process is influenced by a range of factors, from genetic effects to skin type, and also susceptibility to swelling, especially in thyroid and kidney disease.

The objective of plastic surgery of the eyelids is to remove excess skin and fat tissue pushing through underneath, which results in an older and more tired appearance.


Frequently Asked Questions

Plastic surgery of the  eyelids is suitable for women or men. Lower eyelid surgery is most commonly performed for clients over 40 years of age, but it can be performed earlier where there is a particular anatomical predisposition.

The first and most fundamental step before deciding to undergo plastic surgery of the lower eyelids is an initial consultation. On the basis of an examination, the doctor will suggest the most suitable type of procedure. If this procedure suits you, the doctor will give you full details about the procedure, including anaesthesia method.

Before plastic surgery of the upper eyelids, you need to undergo a pre-operation examination, which your general doctor will provide. This examination will include laboratory blood tests, including coagulation value, laboratory-determined liver function values, mineral content, etc. A cardiac function assessment is only needed for operations under general anaesthetic, or for patients over 40 years of age and patients with heart problems.

Before the operation, we do not recommend taking medicines such as Acylpyrin, Alnagon, Aspirin and Mironal, which may cause increased bleeding during and after the operation. Clients who take blood thinners (e.g. Warfarin) should consult with the doctor treating them on whether they should stop taking them temporarily.

On the day of the operation, you should arrive at the clinic at the agreed time. Bring with you your pre-operation examination results, which must include a statement from your general doctor that the operation is appropriate for you. The pre-operation examination must not date to earlier than 14 days prior to the operation.

Lower eyelid surgery can be performed in two ways:

External approach:
The incision is made just below the edge of the eyelid, at approx. 1mm. Fat prolapses (fat cushions) are subsequently removed, and the wound is closed using a fine intradermal stitch. The operation is performed under local anaesthesia.

Internal approach:
This technique can be used for clients with fat prolapses without excess skin.

The incision is made from the inside of the lower eyelid through the palpebral conjunctiva, after which excess fat is removed. Usually the wound does not need a stitch, and the conjunctiva is left to heal on its own. You usually receive this type of operation under general anaesthesia to ensure greater client comfort.

Lower eyelid surgery takes around one hour.

If the operation is performed under local anaesthesia, you leave for home after the operation. We recommend ensuring you are escorted home, and also that you wear dark glasses. Your eyes may be more sensitive to light shortly after the operation.

After an operation performed under general anaesthesia, you will stay at the clinic for one day, during which time you will be under constant care, and you will be released for home care the second day.

Before leaving for home, you will be informed in detail about post-operative care at home.

During the post-operative period, it is a good idea to take things easy and apply cooling compresses to prevent excessive swelling and bruising. The most visible swelling will disappear if kept thoroughly cool within a few days. It is a good idea to sleep with your head in a raised position and limit physical activities which might result in increased blood pressure for a week.

During the first 24 hours, it is a good idea to apply cold compresses (cooling gels) to the eyelids over a sterile dressing for 30-minute periods, followed by a 30-minute break. You do not need to cool the eyelids overnight.

On day two following the operation, carefully remove the bandage from your eye. Leave the thin elastic plaster on the skin. It is important that this plaster not get wet for a period of 7 days, and that you continue cooling it by applying ice over an ironed handkerchief so that the plaster remains dry.

On day three following the operation, you should continue to cool the eyelids, but you need not do so to the same large degree. Swelling and bruising will appear on your eyelids after the operation, and these will remain for 2-3 weeks. This is natural and nothing to worry about.

On day seven after the operation, you should arrive at the clinic to get your stitches out. The plaster on your eyelids should remain there until the stitches are removed. If the plaster comes away before this, you should visit the clinic to reattach it. Once the stitches have been removed, you no longer need to cool the eyelids. Instead, continue applying an elastic bandage over a handkerchief only overnight. This prevents damage to the wounds while sleeping. Apply an elastic bandage overnight for at least the first 10 days following the operation.

On day 13 after the operation, you can begin with gentle massaging of the wounds. Gently press down on the wound with the tip of your finger, and apply pressure for around 30 seconds, then move your finger to another part of the wound. You should massage your wounds in this way a few times each day. You can use an unperfumed oil-rich cream or olive oil.
After surgery, you should avoid exposure to sunlight for a period of 2-3 months. It is also a good idea to protect your eyelids using a high SPF cream.

Clients can undertake undemanding office work from the third day after the operation, but you should expect significant swelling and bruising, which will remain for a period of around 1-2 weeks.

The final outcome of the surgery is seen after 4-8 weeks, once the swelling has gone completely and the scar should be almost invisible.