Upper eyelid correction

Upper eyelid correction has become one of the most popular procedures in aesthetical medicine. Dr. Sawatzki uses his experience to explain various methods and problems.

Now you can read all methods, problems and costs of eyelid lifting in 10 minutes.

An open eye and a clear view usually disappear when drooping eyelids become noticeable from the age of about 40. However, there is medical help available, where an experienced plastic surgeon can improve the aesthetic sensation and gaze significantly.

However, the interested patient often does not realize that there are numerous methods that can be used depending on the indication and the doctor should very carefully examine the causes and the findings first.

Upper eyelid lifting or eyelid correction is a relatively simple surgical procedure. It is more important to understand an aesthetic sense of skin and tissue structures and to achieve a natural result.

In addition, a very good doctor recognizes problem areas such as bags under the eyes, rings under the eyes and crow's feet and will clarify with the patient what he wants as a result. The eyelid lift alone cannot be effective and the patient is dissatisfied.

Inhalte

1. Operative Methode
2. Methoden ohne OP
   • Plasmage – Plasma Pen
   • Hochfrequenz
   • Thermalifting oder "Thermage"
   • Laser
   • Blitzlampen
3. Fazit

1. Surgical method

A few years ago, there was only the upper eyelid surgery to tighten and correct drooping eyelids. In the meantime, however, there are minimally invasive techniques which have limitations.
If the drooping eyelids are very pronounced and the skin is considerably flaccid, there is currently only the surgical method as a solution.

Before a planned eyelid plastic surgery (synonyms: blepharoplasty, eyelid surgery, eyelid lifting), various other examinations are necessary, which are not deepened here, but are known under: Corneal sensitivity, basal tear secretion, condition of lens and retina, ptosis and pseudoptosis and many more.

A recommendation which is sensible and necessary. The ophthalmologist should perform a special examination beforehand.

When does the surgery make sense?

First of all, the question arises for you as a patient as to when the eyelid lift surgery is sensible and necessary. The upper eyelid lift is first of all an aesthetic treatment. With the Snap Test the doctor controls the "elasticity" of the skin.

If the snap test is positive, i.e. if the skin is lifted, it does not purr back immediately, but stops for the time being.

Surgical measures do not always mean the use of a scalpel, but can also be performed by high frequency or laser. As elegant as these methods may seem, there are risks involved. In addition, the higher technical effort is reflected in the price.

Dr. Sawatzki's experience corresponds to the motto: "Less is more". The classic OR compensates for apparent advantages of alternative high-tech equipment if proper preparation and clean working techniques are used.

Video Eye-lid operation

See an example of an eyelid lift by Dr. Sawatzki at the model and celebrity.

Surgical procedure

The surgical correction of drooping eyelids is a relatively simple procedure for the experienced cosmetic surgeon and takes about 40 minutes under local anesthesia.

Here, after carefully marking the excess skin on the upper eyelid under local anaesthesia, only the excess skin wrinkle is surgically removed. The underlying muscle and fat tissue is not affected. After careful hemostasis, the wound is closed with very fine sutures or tissue adhesive, the scars in the natural skin fold are later almost invisible. Stitches are removed after 5 to 6 days.

During the healing process, the wound is carefully cared for with appropriate ointments. After five days at the latest, the stitches can be removed.

Frequent cooling, wearing sunglasses, avoiding sports and mechanical influences support the rapid healing process. They are socially acceptable again within a week, the result lasts for years.

Beratung	Ausführliche Beratung
Operation	ca. 40 min.
Betäubung	nur Lokalanästhesie
Aufenthalt	ambulant
Gesellschaftsfähig	nach ca. 7 Tagen
Narben	kaum sichtbar
Sport & Freizeit	nur leichte Belastung, anfänglich vermeiden
Sonstiges	Fäden nach 5 - 6 Tagen entfernt

Price

You will receive a clear cost breakdown from us after a preliminary inspection. In the diagnosis and the treatment plan a price can then be stated seriously, because for a great result it can be necessary to treat for example also the tear sacs.

Price approx. 1950.- to 2950.- EUR *

* depending on treatment and separate expense, as at: 2018

Jetzt unverbindlich anfragen

2. Methods with no surgery

For some years now, minimally invasive methods have been established in which drooping eyelids are treated or upper eyelid corrections carried out without a scalpel and without the need for classical surgery. There is a good trend in techniques, which should, however, be coordinated in individual cases.

Do not succumb to the error of thinking "without surgery" is a great advantage. For you it is ultimately a matter of a lasting natural result.

2.1 Plasmage – Plasma Pen

The new method is often referred to as "upper eyelid lifting without surgery" and has the advantage of being minimally invasive.

Developed especially for eyelid tightening, it stimulates a tightening of the eyelid by micro wounds on the skin surface, without risk for the eye. Due to the low energy of 3 watts - in comparison, the power of laser or radio frequency devices is usually around 10 - 50 watts - and the sterilizing properties of the plasma can heal the treated skin areas very quickly.

How it works

Plasma is one of the aggregate states (solid, liquid, gaseous, plasma). Plasma is the fourth of these states to occur in auroras and thunderstorms. In medicine, plasma has been used for years to treat chronic wounds and in ENT surgery.

The device generates an atmospheric plasma by discharging electrical energy as soon as the needle tip is brought approx. 0.5 mm close to the skin surface. However, electrical current does not flow through the patient's body. It seems as if mini flashes are created like a lighter. The resulting energy release is pulsed and causes a tissue heating, which is needed to achieve the sublimation, the actual effect and without damaging it.

In physics, sublimation is the transition of a substance from a solid to a gaseous state of aggregation. This produces heat.

Treatment

The duration of treatment is approx. 20 to 60 minutes. Due to the previously applied local anaesthesia, the treatment is only associated with minor pain.
The healing time of 3 - 4 days is very short and the onset of effect is immediately visible. The wrinkle is smoothed.

Depending on the initial findings, one or two treatments at intervals of 4 weeks are necessary. Direct sunlight should be avoided for the first four weeks after the treatment.

Risks and side effects

Complications, such as pigment damage due to tissue overheating, are unlikely because the effect occurs only at the point where the plasma hits. The risk of unintentional deep penetration is therefore very low, unlike with lasers or high-frequency procedures.
Costs.

Costs

Depending on the doctor, clinic or practice, the costs are approx. 900 EUR. The success is similar to that of normal ageing.

2.2 High frequency

High-frequency radiomicrosurgery differs from conventional electrosurgery in a number of essential respects. Similar to the use of different wavelengths in X-rays and radiation therapy, modulating the frequency in electrosurgery causes a different degree of unwanted collateral tissue damage.

The advantage of electrosurgery, i.e. being able to combine incision and coagulation in a single work step, can only be exploited in the skin area by high-frequency radiosurgical equipment due to the thermal collateral damage, since thermal damage is minimal here.

Dr. Sawatzki's experience with this method. The success or the result ultimately depends on the surgeon's handling, i.e. possible advantages such as shortening the healing time or minimizing the risk are relative and can even turn into the opposite.

For smoothing the skin on the upper eyelid without an incision, there are no handpieces that work exactly, unlike for the application on the lower eyelid.

2.3 Thermalifting oder "Thermage"

Seit 2001wird in den USA das ThermaCool-System der Firma Thermage zur Gewebestraffung und Faltenbehandlung angewendet, die auch auf einer Radiofrequenz-Technologie basiert. Jedoch nicht invasiv. Die Hautoberfläche bleibt intakt.

Behandlung

Die Sitzung dauert 60 - 90 Minuten. Dabei werden bis zu einer Tiefe von 5 mm RF-Impulse in die Haut abgegeben, das Gewebe dort erwärmt und dies führt unmittelbar zu einer Schrumpfung der Kollagenfasern.

Im Laufe der folgenden 9-12 Monate kommt es zur Gewebestraffung durch die Kollagen-Neubildung. In 10-15% der Fälle ist das Ergebnis nicht vorhersehbar. Der Eingriff ist trotz des Anwendung eines Kältesprays etwas schmerzhaft und kann eine operative Hautstraffung nicht ersetzen.

Kosten / Preise

Die Kosten sind je nach zu behandelnden Areal ab 1.000 Euro (Stirn) bis 3.500 Euro (Gesicht komplett)

Weiterentwicklungen habe zu wesentlich aufwendigeren HF-Geräten geführt, die noch anwenderfreundlicher geworden sind. Nachteil all dieser nicht invasiven HF-Verfahren ist, dass mehrere Sitzungen benötigt werden, um den gewünschten Straffungs-Effekt zu erhalten.

Die Kosten liegen beginnen hier bei 250 Euro, je nach zu behandelnden Areal.

Risiken / Ausnahmen

Nicht behandelt werden dürfen Patienten mit Herzschrittmacher oder Defibrillator, Diabetes mellitus, Schwangere oder Stillende und nach einer Unterspritzung mit einem Filler.

2.4 Laser

Das gemeinsame Arbeitsprinzip der Laser basiert darauf, dass sie letztlich mit konzentrierter Hitzeenergie arbeiten, die dem Gewebe zugeführt und die Gewebefasern dazu bringen soll, sich zu verquellen um einen sogenannten Shrinkingeffekt zu erreichen. Dieser bedeutet, dass sich sich Kollagenfasern zusammenziehen und die Haut sich darüber strafft.

Zu erwähnen sind vor allem

1. CO2-Laser
2. ultragepulste CO2-Laser
3. Erbium: YAG-Laser
4. gepulsten Erbium:Glass-Laser (Fractional TM-Laser)

Die drei Ersten Lasertypen basieren auf einer sogenannten Laser unterstützten Dermablation (Hautabtragung). Die Wirkung ist ähnlich wie in bei HF-Technik. Durch Zuführung von gebündelter Lichtenergie werden bestimmte Hautschichten erwärmt, die Kollagenfasern schrumpfen und werden im Laufe der Zeit neu gebildet. Gleichzeitig wird die oberste Hautschicht geschält.

Die Haut ist anschließend ca. für eine Woche gerötet. Pigmentverschiebungen sind möglich. Eine örtliche Betäubung ist notwendig. Sonnenschutz und entsprechende Salben sind erforderlich.

Der Effekt ist wirklich beeindruckend. Aber die Dosis in der Behandlung hat die höchste Priorität.

Wird die Energie zu gering gewählt, passiert nicht viel. Die oberflächliche Haut erlebt den Effekt wie bei einem Sonnenbrand und heilt genauso aus ohne dass sich eine Verbesserung des Erscheinungsbildes einstellt.

Wählt man dann weitere Durchgänge in dem Glauben damit einen positiven Effekt zu erreichen,, besteht die Gefahr der Verbrennung nicht nur der oberen Hautschicht, sondern auch der tieferen Ebenen. Es entsteht eine Verbrennungsnarbe, die das Gewebe sehr stark zusammenzieht. Es resultiert eine Überkorrektur, die zu einer unvollständigen Augenschluss und der Austrocknung des Auges führen kann. Im schlimmsten Fall wäre sogar der Augapfel selbst betroffen.

Diese Problematiken sind nur aufwendig und kostspielig zu korrigieren. Manchmal gar nicht oder es resultieren Sehstörungen, die bleibend sind.

Dies soll mittels dem Fractional-Laser nicht geschehen, denn er setzt mit seinen Miniimpulsen mikroskopisch feine Löcher in die Haut, die eine Hauterneuerung durch den Heilungsprozess bewirken sollen. Um die Minilöcher bleibt die Haut intakt und heilt ohne Nässen oder Schorf ab.

• Es gelten die gleichen Vorsichtsmaßnahmen wie Sonnenkarenz etc.
• Indikationen sind insbesondere Knitterfältchen im Gesicht , Dekolleté etc.
• Notwendig sind 4-6 Sitzungen in 4-wöchigen Zeitabständen je 250 Euro.
• Kombinierte Anwendungen sind möglich.

2.5 Blitzlampen

Hochenergetische Blitzlampen (IPL) arbeiten in einem Wellenlängenbereich zwischen 400 und 1200 nm. Sobald das Licht die Haut erreicht, wird es in Hitzeenergie umgewandelt. Im Bereich zwischen Hautoberfläche und Kollagen kommt es dann zur Zerstörung des Farbstoffes des Blutes, dem Oxyhämoglobin.

Das Ziel ist die Kollagen-Neubildung, Beseitigung von erweiterten Äderchen, die Entfernung von Pigmentflecken und die Verkleinerung der Poren zur Hautglättung.
Gut geeignet zu Couperose-Behandlung. Tiefe Falten jedoch werden nicht beeinflusst.

• 4 - 6 Sitzungen zu 30 Minuten sind erforderlich.
• Eine komplette Gesichtsbehandlung kostet ab 350.- Euro.

Risiken / Ausnahmen

Nicht behandelt werden dürfen Schwangere, Patienten mit Diabetes, mit gebräunter Haut (Pigmentverschiebungen!) und nach Einnahme von gerinnungshemmenden Medikamenten oder bei Gerinnungsstörungen.

Result

As a patient, you now know numerous methods and techniques that differ in their application as well as in their prices. More important than the method is a natural and lasting result.

Slip eye is not the same as slip eye.

The exact classification into the different characteristics and the knowledge of their causes point the way to the right therapy.

Technical innovations have limited application possibilities and are often only successful after several sessions. For patients who do not want a surgical intervention, this can be an alternative if the appropriate conditions are met. Nevertheless, the initially invisible dangers of technology as well as its limited possibilities must be pointed out here.

"Without surgery", "without scalpel" are partly possible and are used for the medical and aesthetic indication of Dr. Sawatzki.

In older patients with low skin tension on the upper eyelid, as well as problems such as lacrimal sacs, brows stenosis, Doggy Eeyes, frown lines, etc., the surgical method will achieve the best result.

With Dr. Sawatzki you can rely on the experience of hundreds of upper eyelid operations and eyelid corrections. In a personal conversation you will be shown pictures beforehand and afterwards and the challenges of each individual patient will be explained.