Prof. Ben Simon, an ophthalmologist specializing in aesthetic surgery, explains upper eyelid lift – Upper Eyelid Blepharoplasty.
Over the years, there is a natural phenomenon of excess skin forming in the upper eyelids, accompanied by sagging or sagging fat. Sometimes this is true drooping eyelids, or in medical terminology, ptosis , a lower-than-normal eye opening.
This condition can significantly affect the patient’s quality of life, both functionally and aesthetically. The phenomenon manifests itself in a restriction of the field of vision, especially in the upper part, and creates difficulty in performing daily activities such as reading, driving, and viewing screens.
Many patients report a constant feeling of fatigue resulting from the need to frequently use the forehead muscles to lift the eyelids, an effort that often leads to headaches and general fatigue. Beyond the functional aspect, drooping eyelids affect the external appearance, creating a tired and older appearance, and sometimes even impairing the ability to express natural facial expressions.
Eyelid lift is one of the most sought-after procedures in oculoplastic surgery due to its ability to improve both function and appearance. As the skin loses elasticity and muscles weaken over time, excess skin and fat can cause a tired appearance and even reduce the field of vision. Eyelid lift surgery addresses this problem precisely and restores a fresh, open look to the eyes. When patients examine eyelid lift before and after photos, they discover how a subtle change around the eye can affect the entire face and provide an overall sense of lightness.
The causes of eyelid drooping are varied and complex, and it is important to understand them in order to determine the most appropriate treatment.
It is important to understand that eyelid drooping can occur in different forms and varying degrees of severity. There are cases of mild drooping that is barely noticeable, and on the other hand, there are severe cases in which the eyelid covers a significant portion of the pupil and significantly interferes with vision. The drooping can be unilateral or bilateral, symmetrical or asymmetrical. In some cases, the phenomenon develops gradually over years, while in other cases it appears suddenly. The sudden appearance of a drooping eyelid requires immediate medical investigation, as it may indicate a serious medical problem that requires urgent treatment.
The benefits of the surgery extend across several significant areas of the patient’s life, from substantial functional improvement in vision to significant aesthetic changes in facial appearance.
The surgery is suitable for men and women who suffer from congenital or acquired eyelid ptosis, partial vision due to the eyelid covering the pupil, a feeling of heaviness and poor aesthetics. In most cases, this is a process that parallels natural puberty, but young people with a genetic predisposition may also need treatment. Beyond the cosmetic aspect, it is important to remember that significant eyelid ptosis may cause excessive strain on the forehead muscles and chronic headaches – a condition whose solution lies in precise eyelid lift surgery.
In situations where the drooping eyelid impairs the field of vision, eyelid lift surgery is considered a medical procedure and may be recognized by health funds or private health insurance. When the problem is purely aesthetic, the cost is borne by the patient. Already in the first consultation, Professor Ben-Simon separates the two categories and explains which tests are required for participation certificates, if there is medical justification.
The consultation begins with an in-depth discussion about the goals of the surgery, a review of the medical history, and a comprehensive clinical examination. Using computerized close-up photographs, the doctor demonstrates to the patient the expected changes and compares them to an archive of eyelid lift before and afters. This way, realistic expectations regarding the height of the fold, possible scars, and the recovery process from eyelid lift surgery are coordinated.
The chosen technique is customized for each patient depending on the structure of the eyelid, the amount of excess skin, and the degree of muscle sagging:
The first step in preparing for surgery is the preliminary meeting with the surgeon. During this meeting, a comprehensive assessment of the condition of the eyelids and eyes is carried out, and an in-depth discussion is held about expectations from the surgery. The doctor explains the patient in detail the procedure, the possible results and the expected recovery period. It is very important to be honest with the doctor about expectations and share all concerns and questions. This is also the right time to discuss a complete medical history, including previous surgeries, allergies and regular medications.
On the day of surgery, you must come with a 6-hour fast from food and water, as the surgery is usually performed under local anesthesia with intravenous sedation. Children may drink water up to 4 hours before surgery (if you have diabetes, consult your doctor regarding diabetes medications). If you are taking blood thinners/anticoagulants, you must stop taking them a few days before surgery as recommended by the surgeon and with the approval of the doctor. You must come with a companion to the surgery, as you cannot drive or return alone by public transportation due to the effects of the anesthetics and due to local swelling after surgery.
The surgeon marks the excess skin on the eyelids with a fine marker. After anesthesia, the excess skin is removed, and the incision is closed with a long, fine stitch. The incision is made in the natural crease of the eyelid, so that there is almost always no visible scar after the surgery. The surgeon uses precise surgical instruments and advanced microsurgical techniques, which allow for maximum precision and minimizes trauma to the tissues. If there is true ptosis, the muscles responsible for opening the eyes are shortened.
In some cases and depending on the aesthetic disorder, excess fat in the eyelids is removed or repositioned, the tear gland is fixed, and the eyelid height is corrected when there is drooping eyelids associated with excess skin. In cases where there is a lack of fat in the eyelid (sunken eyes), autologous fat injection may be considered to give the eyelids and upper face a fuller, more youthful appearance.
Throughout the entire operation, great emphasis is placed on maintaining symmetry between the two eyes. The surgeon frequently checks the position of the eyelids and makes subtle adjustments as needed. At the end of the operation, a careful examination of the initial result is performed, ensuring that the eyelids are positioned at the planned height and that symmetry is maintained.
The entire surgery usually takes between one and two hours, depending on the complexity of the case and the extent of the correction required. At the end of the surgery, cold compresses are placed on the eyes to reduce swelling and bleeding. The patient is given detailed instructions for eye care in the first few days after surgery, including the use of antibiotic eye drops and special ointments.
Patient safety is a top priority throughout the entire process. The surgery is performed in a sterile operating room, under constant medical monitoring. The surgical team includes, in addition to the surgeon, a registered nurse and other staff members who specialize in eye surgery.
Gentle cooling of the eyelid area is recommended for the first 48 hours to reduce swelling. Because the skin in the area is thin, minor bruising is common and usually disappears within seven to ten days.
The recovery process from eyelid lift surgery is gradual and requires patience and meticulous care. Full recovery takes several weeks, with each stage of the process characterized by different symptoms and requiring tailored attention and treatment.
The surgery itself is performed under local anesthesia with or without sedation and does not take long. After the surgery, there may be swelling in the area that will gradually decrease in the weeks leading up to the surgery. Naturally, there may also be mild pain after the surgery. The pain can be managed with OTC medications. It is important to maintain the area clean and adhere to the nursing instructions that you will receive upon discharge home in order to prevent infection and ensure optimal recovery.
After the surgery, stitches or staples will remain in the surgical incision for a period of two weeks, at which point you will need to come to the clinic to have them removed. Any tiny scars that remain will disappear almost completely over time and will in any case be invisible to the eye.
As part of the recovery process from eyelid lift surgery, during the first few weeks after surgery, there may be a numbing sensation in the surgical area. This sensation will naturally subside after a few weeks.
In the first week after surgery, there is slight swelling of the eyelids, with subcutaneous hemorrhages. Vision is usually normal and there is no impediment to performing routine activities except for strenuous physical activity or swimming in a pool. It is common to apply antibiotic ointment to the surgical wound for a week, as well as to place cold compresses for the first two days after surgery, in order to reduce swelling. After 7-14 days, the stitches are removed in the clinic. The final result of the surgery is observed about one to three months after surgery.
Recovery from eyelid lift surgery is greatly influenced by following the doctor’s instructions – rest, avoiding sun exposure, and gentle massage as recommended. Those who follow up at the clinic find that recovery after eyelid lift surgery becomes more comfortable and shorter, with a reduced risk of prolonged edema or asymmetry.
Most patients enjoy lasting results for ten years or more, depending on skin structure, genetics, and lifestyle. It is important to note that an eyelid lift does not stop the aging process, but it does “reset the clock” and return the eyelid and crease position to a significantly younger starting point.
Eyelid lift surgery is a common procedure and is considered safe. Of course, as with any surgery, there are certain risks.
It is important to emphasize that the more skilled and expert the surgeon and anesthesiologist are in their work, the lower the risk and the better the results may be.
In aesthetic surgeries in particular, the skill of the surgeon has a great impact on the final result, the feasibility of the need for additional surgery, and the complications that may occur during and after the surgery, so it is important to choose a doctor with extensive experience and many hours of surgery. Patients should be aware of unusual signs and not hesitate to contact their doctor with any questions or concerns.
Awareness of possible risks and early identification of problems allow for quick and effective treatment, leading to better results in the long term.
The consequences of eyelid drooping on the patient’s quality of life are significant and multidimensional. In addition to impairing vision and aesthetic appearance, the phenomenon affects social and emotional functioning. Many patients report a decrease in self-confidence and a general sense of well-being. The constant need to raise the head or eyebrows to improve the field of vision creates unnatural body postures, which can lead to neck and back pain. In addition, the constant effort to overcome the drooping causes increased fatigue and a decrease in efficiency at work and in daily activities.
It is important to choose an ophthalmologist with a specialization in eyelid surgery – oculoplastics, a unique field that focuses on upper eyelid surgery, lower eyelid surgery (sags under the eyes), forehead and eyebrow lifting, and eye socket and tear duct surgery. As well as having experience in eyelid surgery, who will be able to diagnose and adjust the surgery or treatment required for you. It is recommended to see before and after surgery photos of other patients in order to adjust expectations, and sometimes it is even possible to consult with patients to understand the experience of treatment and recovery.
During the meeting, an initial introduction is made, the patient’s wishes are understood, and expectations are adjusted to the possible outcome. Prof. Ben Simon performs a comprehensive examination of the eye to assess diseases and associated conditions that will require adjustment of the surgery to eye health. A comprehensive examination of the eyelids is also performed, including all aesthetic and functional disorders that can be improved. After a discussion with the patients, an optimal treatment plan is implemented. In most cases, the solution is surgical, but in other cases there are non-surgical treatments such as Botox injections, peeling, or fillers .
After the examination, patients go to the clinic manager to complete tests and receive the technical details of the surgery, including scheduling an appointment.
The clinic team includes Miri Sapir, who receives the patient, completes some of the preliminary tests, and serves as an aesthetic consultant, along with Anna Kasner, the clinic manager, who coordinates the surgeries and obtains full details about the nature of the process.
Eyelid lift surgery can restore them to their previous position depending on the cause of the drooping. In cases where there is drooping eyebrows and no specific eyebrow lift surgery is performed, eyelid lift surgery will not change the condition of the eyebrow, and sometimes may even cause a slight drooping of the eyebrow.
Eyelid lift surgery is usually performed at the age of 40 and older, although in some cases it may be performed at a younger age. As you get older, there are associated effects such as fat loss, fat absorption, lacrimal gland prolapse, and relative drooping of the forehead and eyebrows. Before making a decision, you should consider each of the above issues and adapt the surgery to the patient’s expectations and wishes.
In cases where there is drooping eyebrows and no specific eyebrow lift surgery is performed, eyelid lift surgery will not change the condition of the eyebrow, and sometimes may even cause a slight drooping of the eyebrow.
Most patients experience only mild discomfort that can be controlled with regular painkillers.
The significant swelling decreases within a week, and in the first month the eyelid continues to refine.
Usually after two to three weeks, subject to the doctor’s approval.
Yes, in many cases, eyebrow lifting or tear trough filling is combined to obtain a holistic result.
The choice is made based on a clinical examination, skin thickness, amount of fat, and distance of the eyebrow from the eye – all details are discussed during the consultation.
Eyelid lift is an advanced procedure that combines surgical expertise with a deep aesthetic understanding. Professor Guy Ben Simon , with many years of experience in oculoplastic surgery, performs eyelid lift surgery using state-of-the-art methods that ensure a natural result and minimal recovery time. If you are considering the procedure, schedule a personal consultation and examine the eyelid lift before and after photos for yourself – and discover how to restore the open, clear look to your eyes that has been lost over the years.
MEDICA Medical Center, HaBarzel 28, 1st floor, Ramat HaHayal, Tel Aviv
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