Lower eyelid lift (lower blepharoplasty)

The lower eyelid lift is performed either on its own or in combination with a midface lift, usually under local anaesthesia in the context of outpatient treatment (of course also under full anaesthesia upon request). “Eye bags” and “looking tired” are the motives most often reported by patients coming to our centre for a consultation.

Surgical technique

It is differentiated whether a combination of skin, muscle and fat removal is indicated. Access is then either directly underneath the eyelashes or, if only excess fat is to be removed, within the mucosa of the lower eyelid (no visible scars).
During surgery, the patient is asked several times to close and/or open the yes to allow a precise evaluation of the excess skin and muscle, because it is very important to avoid excessive downward pulling force with the risk of “ectropion” or “scleral show”. 
If the midface is sagging, the same access route can be followed to apply a preparation technique to the bone and then below the periosteum to the nasolabial fold. This means that the soft tissue is completely mobilized and can be repositioned upward, where it had been at a younger age. There are several options for fixation, such as on the outer margin of the eye socket (lateral orbits), the lower margin of the eye socket (infraorbital margin), and others.

Arcus marginalis release

In an arcus marginalis release, all three fat pads in the region of the lower eyelid are extracted, placed in the lower eyelid/midface region for filling (“sliding fat pads”) and temporarily fixed in place by means of so-called removal sutures. The removal sutures are secured using Steri-Strips and removed after three days at the latest.
At the end of surgery, fine adhesive bandages (Steri-Strips) are applied for 5 days and, depending on whether the skin has been “bonded” or stitched, the bandage and/or suture material is removed.