Lower Eyelid Lift in Berlin with Dottore Caletti
Compared with other areas of the body, the skin around the eyes is particularly thin and delicate. Environmental factors and the natural ageing process often become apparent in this area at an early stage.
Lines around the eyes, hooded upper eyelids and under-eye bags can markedly alter a person’s appearance. Eyelid surgery is therefore one of the most frequently performed procedures in plastic and aesthetic surgery. Depending on where these changes occur, an upper or lower eyelid lift may be appropriate.
Dottore Caletti performs lower eyelid lift surgery in Berlin and will be pleased to answer your questions during a personal consultation.
- Procedure duration
- Approximately two hours
- Anaesthesia
- General anaesthesia
- Hospital stay
- Outpatient procedure
- Ready to socialise
- After two weeks
- Return to work
- After two weeks; three to four weeks for physically demanding work
- Exercise
- After four weeks
- Initial wound healing
- Two weeks
- Cost
- From €3,000, depending on the extent of surgery and the technique used
- Aftercare
- For the first few days, cool the eye area, keep your head slightly elevated and avoid physical exertion. Do not apply creams or make-up around the eyes. Sutures are removed after approximately one week
Before surgery, I mark the planned incisions on your lower eyelids with a surgical skin marker. You will then receive a general anaesthetic. I perform the lower eyelid lift carefully using a scalpel. Removing excess, lax tissue and tightening the remaining skin requires meticulous plastic surgical technique. The incisions are then sutured. The procedure takes approximately two hours, and the sutures are removed after around one week.
A lower eyelid lift is generally considered a low-risk procedure. When performed by an experienced specialist in plastic and aesthetic surgery, serious complications are uncommon. Nevertheless, as with any operation, risks cannot be ruled out entirely. These include delayed wound healing, infection, scarring and bleeding. To minimise these risks, I recommend avoiding sleeping tablets, painkillers and blood-thinning medication for at least one week before surgical treatment of under-eye bags, provided this has been agreed with the prescribing doctor. Ideally, you should refrain from smoking and drinking alcohol during this period and for the first few weeks after surgery, or reduce both as far as possible. Minor bleeding, watery or dry eyes and altered sensation around the eyes may occur during the first few days. At first, you may also be unable to close your eyelids completely. These symptoms can occur after a lower eyelid lift and are usually temporary. If you experience more pronounced symptoms or pain, I will of course be available to examine and treat you.
Swelling and mild bruising are to be expected immediately after a lower eyelid lift, but they usually subside within a few days. Continued cooling can ease the associated discomfort. You may use soft cooling packs, a cooling eye mask or special cold compresses, but they must never be applied directly from the freezer. Excessive cooling can encourage further bleeding at the surgical sites. Rest and limited physical activity are also important during the first few days. Significant pain immediately after surgery is uncommon. As a precaution, however, our team will provide pain medication for you to take if required. You will receive lubricating eye drops or an eye ointment for dryness. Keep water away from your eyes for at least three days after surgery. During the first week, avoid massage, scar ointments and make-up to reduce the risk of impaired wound healing and unwanted long-term pigmentation. Your eyes will remain more sensitive than usual for some time. During the first week after eyelid surgery, you should avoid watching television and using a computer. Wear sunglasses outdoors for one to two months. Complete wound healing can take up to six months. Scars that are initially visible and often quite red usually fade considerably during this period.
Facts and Information About Lower Eyelid Lift Surgery
A lower eyelid lift in Berlin is a surgical procedure that removes excess skin and fatty tissue beneath the eyes, including the tissue responsible for under-eye bags where appropriate, and tightens the remaining skin for a long-lasting result.
What Is a Lower Eyelid Lift?
A lower eyelid lift—known medically as lower blepharoplasty—is performed to reduce excess skin and under-eye bags. It smooths lax lower eyelids and bulging beneath the eyes, helping the eye area look fresher and more youthful.
What Causes Under-Eye Bags?
Contrary to a common misconception, under-eye bags are not accumulations of tear fluid in the lower eyelid. They develop when the connective tissue beneath the eyes becomes lax. In addition to skin ageing, lack of sleep, stress and genetic predisposition may contribute to their appearance.
A basic understanding of the anatomy of the eyes and eyelids helps explain how under-eye bags develop.
Understanding the Anatomy of the Eye Area
The lower eyelid consists of several layers of tissue. The uppermost and visible layer is the skin, bordered above by the lash line immediately beneath the eye. Below the skin lies the orbicularis oculi muscle, which enables us to open and close our eyes.
Behind the orbicularis oculi muscle are the lower eyelid fat pads, covered by a thin layer of connective tissue. This layer also contains the tarsal plate, which gives the lower eyelid its shape and stability.
Small fat pads beneath the eyes are therefore entirely normal. Under-eye bags develop when this fat becomes more prominent and the skin and connective tissue begin to bulge outwards. The innermost layer of the lower eyelid is the conjunctiva, a mucous membrane that allows the eyelids to glide smoothly over the surface of the eye.
The bony rim of the eye socket marks the transition between the lower eyelid and cheek. Environmental factors and natural ageing gradually thin the tissue beneath the skin, which can lead to dark circles under the eyes that many people also find cosmetically troubling.
Why Lower Eyelid Surgery Requires Particular Care
The upper eyelid moves actively when the eyes open and close, whilst the lower eyelid provides stability through the counterpressure generated by the orbicularis oculi muscle. To achieve a good result and reduce the risk of complications during lower eyelid surgery, it is essential to protect this muscle and the nerves running through it. This is an important reason why eyelid surgery should be performed only by an experienced doctor with a detailed understanding of the entire anatomy of the eye area.
As the skin and connective tissue beneath the eyes lose elasticity, the lower eyelid gradually descends. At the same time, fat beneath the eyes may become more prominent, forming under-eye bags. This further stretches the skin, making it appear more lined and lax.
Under-eye bags are almost always a cosmetic concern and only rarely indicate an underlying medical condition. One possible medical cause is malposition of the eyelid. A lower eyelid lift can provide long-lasting improvement in under-eye bags and may also address certain forms of eyelid malposition.
When Is a Lower Eyelid Lift Appropriate?
A lower eyelid lift may be appropriate when lax lower eyelids and under-eye bags alter your overall facial expression. Weakened connective tissue and prominent fat pads can make the eyes appear smaller and puffy, whilst lines beneath the eyes become more noticeable. The face may appear tired, downcast and older than it is. Age-related weakening of the orbicularis oculi muscle can contribute to these changes. If they affect how you feel about your appearance or your quality of life, lower eyelid surgery may be worth considering.
If you visit my Berlin practice to discuss a lower eyelid lift, I will assess you carefully and advise you in detail before we decide together whether surgery is appropriate and which approach is best suited to you.
What Results Can a Lower Eyelid Lift Achieve?
A lower eyelid lift can reduce both under-eye bags and lines beneath the eyes. During the approximately two-hour operation, I remove excess skin, lax tissue and prominent fat from the lower eyelid. The remaining skin is tightened, significantly softening lines around the eyes. Where appropriate, treatment of the lower eye area may be combined with an upper eyelid lift.
As the incision is placed just beneath the lash line, the resulting scar is usually barely noticeable once healing is complete. Following a lower eyelid lift, the eyes—and often the face as a whole—can appear fresher and more youthful. The extent of surgery depends on the condition of your eyelids and the prominence of the under-eye bags. The final result becomes apparent after several weeks and lasts for an average of more than ten years, although the natural ageing process continues.
Combining a Lower Eyelid Lift with Other Treatments
A lower eyelid lift can be combined with other treatments to achieve a balanced aesthetic result. Options include injectable wrinkle treatment, treatment of dark circles, or facial contouring with fillers such as hyaluronic acid or your own fat. These treatments can help the face look fresher and more youthful overall.
Lower eyelid laxity often occurs alongside changes in the upper eyelids. Where the upper eyelid has also lost firmness, combining lower eyelid surgery with an upper eyelid lift may produce a more balanced result.
Benefits of a Lower Eyelid Lift
A lower eyelid lift can create a more open, refreshed appearance around the eyes. By tightening the skin and connective tissue beneath the eyes, it can significantly reduce under-eye bags. Even when treatment is limited to the lower eye area, the face may appear younger and firmer overall, with less visible lines beneath the eyes.
Which Lower Eyelid Lift Techniques Are Available?
There are two principal approaches to lower eyelid surgery: the transcutaneous and transconjunctival techniques. The method used depends on the patient’s individual anatomy and treatment needs. The transconjunctival approach is not suitable when a significant amount of excess skin must be removed to tighten the lower eyelid effectively.
If you choose to have your lower eyelid lift in Berlin, I will explain both surgical approaches and why I recommend a particular technique in your case.
Transcutaneous Lower Eyelid Lift
In a transcutaneous lower eyelid lift, an incision is made in the skin close to the lower lash line. Excess skin and fatty tissue are then removed. If additional contouring of the lower eyelid or other areas of the face is required, the harvested fat pads may also be used for lipofilling, also known as fat transfer. The incision leaves a fine scar that is usually barely visible once healing is complete.
Transconjunctival Lower Eyelid Lift
In a transconjunctival lower eyelid lift, the incision used to treat under-eye bags is made through the conjunctiva on the inside of the lower eyelid. “Conjunctiva” is the medical term for the membrane lining the inner eyelid. This approach leaves no visible external scar.
Treating Under-Eye Bags
In addition to the position of the incision, several other considerations influence the techniques used for a lower eyelid lift. These depend on the patient’s individual anatomy and clinical findings.
The following examples describe techniques that may combine lower eyelid surgery with plastic surgical treatment of other cosmetic concerns. A lower eyelid lift can reduce under-eye bags and be combined with treatment to reduce dark circles. A sheet of connective tissue beneath the eyes helps retain the fat within the eye socket.
When this tissue becomes lax, under-eye bags can develop; as the connective tissue descends, dark circles or a hollow tear trough may also become more apparent. During lower eyelid surgery, fat can be repositioned upwards so that it adds volume to the hollow area and reduces the appearance of dark circles. At the same time, the lower eyelid is reshaped to create a smoother, more even contour. A lower eyelid lift may also be combined with lipofilling, using your own fat to restore volume beneath the eyes or elsewhere in the face for a fresher overall appearance.
Adjusting Muscle Tension and Removing Excess Skin
A lower eyelid lift may involve tightening the orbicularis oculi muscle and removing excess skin. When selecting the appropriate surgical technique, I assess whether the principal issue is reduced muscle tone, excess skin or a combination of both. With increasing age, loss of muscle tone often has a particularly marked effect on the lower eyelids, so excess skin must be removed conservatively.
Tightening the Eyelid Support Structures
If the eyelids are very lax and overstretched, the lower eyelid may no longer sit correctly against the eye. This change is particularly common with advancing age. Tightening the orbicularis oculi muscle alone may not be sufficient; the supporting structures of the lower eyelid must instead be tightened and secured in a new position.
What Happens During a Lower Eyelid Lift in Berlin with Dottore Caletti?
A physical examination forms an essential part of the detailed consultation and is important for planning and performing lower eyelid surgery safely. The procedure itself may include the following elements:
- Tightening the area beneath the eyes
- Reducing excess skin and removing or repositioning fatty tissue
- Stabilising and tightening the orbicularis oculi muscle to improve support for the tissue beneath the eye.
Preparation and Detailed Examination for a Lower Eyelid Lift in Berlin
In preparation for lower eyelid surgery, I assess all relevant aspects of the anatomy and function of your lower eyelids. The findings determine which techniques are most appropriate and where the incisions beneath the lashes should be placed.
An important part of this examination is assessing the tone of the orbicularis oculi muscle and the stability of the lower eyelid. Inadequate assessment or technique can contribute to complications such as a hollow-eyed appearance or downward displacement of the lower eyelid, which may require prolonged follow-up treatment.
To reduce this risk, very lax lower eyelids require specific stabilising techniques. For several years, the trend in lower eyelid surgery has been to combine tightening with stabilisation of the eyelid from the outset. The preliminary examination also identifies any existing eyelid malposition so that the surgical technique can be adapted where necessary.
On the Day of Surgery
Immediately before surgery, I mark the planned incisions on your lower eyelids with a surgical skin marker. In principle, eyelid surgery can be performed under local anaesthesia with light twilight sedation. Because of the duration of this operation, however, a general anaesthetic is usually administered.
I perform the lower eyelid lift and treatment of the under-eye bags carefully using a scalpel and, in some cases, a radiofrequency probe. Removing excess tissue and tightening the remaining skin require meticulous plastic surgical technique.
The surgical incisions are then sutured. A lower eyelid lift takes approximately two hours. Most patients can return to work and social activities after around 14 days. The sutures are removed after one week, by which time the incisions have begun to heal and are often already inconspicuous.
Immediately After Surgery
After your lower eyelid lift, you will remain under observation at my Berlin practice for one to two hours. You should rest for at least the first three days and avoid physical exertion. Exercise and physically demanding activities can usually be resumed after approximately three weeks, depending on your recovery.
Significant pain immediately after surgery is uncommon. As a precaution, however, our team will provide pain medication for you to take if required. You will also receive lubricating eye drops or an eye ointment to relieve dryness.
If more pronounced discomfort occurs—which is uncommon after a lower eyelid lift—anti-inflammatory medication and keeping the head and upper body elevated may provide relief.
The Days and Weeks After Surgery
Keep water away from your eyes for at least three days after surgery. During the first week, avoid massage, scar ointments and make-up to reduce the risk of impaired wound healing and unwanted long-term pigmentation.
Your eyes will remain more sensitive than usual for some time. Complete wound healing may take up to six months. Any scars that remain visible at first will usually fade considerably during this period.
Risks of a Lower Eyelid Lift
A lower eyelid lift is generally considered a low-risk procedure. When performed by an experienced specialist in plastic and aesthetic surgery, serious complications during or after surgery are uncommon.
Nevertheless, as with any operation, complications and risks cannot be ruled out entirely. These may include delayed wound healing, infection or adverse reactions to medication.
To minimise these risks, I will advise you during your consultation to avoid sleeping tablets, painkillers and blood-thinning medication for at least one week before lower eyelid surgery, provided this has been agreed with the prescribing doctor. Ideally, you should refrain from smoking and drinking alcohol during this period and for two to three weeks after surgery, or reduce both as far as possible.
Immediately after surgery, minor bleeding, watery or dry eyes and altered sensation around the eyes may occur. At first, you may also be unable to close your eyelids completely. These symptoms can occur after a lower eyelid lift and are usually temporary rather than a cause for concern.
Lower Eyelid Lift in Berlin – Detailed Advice and Personalised Treatment with Dottore Caletti
If you are considering a lower eyelid lift at my specialist practice for plastic and aesthetic surgery in Berlin, the first step is a detailed consultation. This gives me the opportunity to understand your wishes and assess your individual anatomy. I will explain how lower eyelid surgery is performed and discuss the possible complications and risks with you.
Frequently Asked Questions
Why Is a Lower Eyelid Lift Performed Under General Anaesthesia?
A lower eyelid lift takes at least two hours. If the surgical area is extensive or the operation is combined with other plastic surgical procedures, it may take longer. As a specialist in plastic and aesthetic surgery, I perform meticulous work on the delicate structures around your eyes. For this reason, general anaesthesia is usually less demanding for both you and me than local anaesthesia with twilight sedation during a lower eyelid lift.
If you would prefer not to have a general anaesthetic, please mention this during your consultation. A lower eyelid lift can also be performed under local anaesthesia. A mild sedative can be administered so that you remain in twilight sedation during the procedure.
How long do the results of a lower eyelid lift last?
The results of a lower eyelid lift generally last around 10 to 15 years. As the natural ageing process continues, a further procedure may eventually be appropriate. This does not create additional scars, as the incisions are made along the existing, very fine scar lines.
Will a lower eyelid lift affect my facial expressions?
When a lower eyelid lift is performed by an experienced specialist in plastic and aesthetic surgery, it should not cause any unnatural changes to your facial expressions.
The procedure does influence the appearance of the eye area and therefore the overall expression of the face, but in a positive and subtle way. Rather than altering your individual expressions, it allows them to appear more clearly by reducing under-eye bags and excess skin. With every treatment, my priority is a natural-looking result that complements your individual features.
Could revision surgery be required after an eyelid lift?
An eyelid lift should always be performed by an experienced specialist in plastic and aesthetic surgery, as this significantly reduces the likelihood of revision surgery. It is also important to remember that the final result will not be apparent until approximately three months after surgery and, in some cases, slightly later. Nevertheless, within a few days or weeks of your lower eyelid lift, you should begin to notice an improvement in the appearance of your eye area and face as a whole.
Can an eyelid lift be combined with other plastic surgery treatments?
In principle, yes. Combining procedures can sometimes be advisable as part of a balanced overall treatment plan. During your consultation at my practice, I will discuss what you would like to achieve and whether a combination is appropriate from both a medical and aesthetic perspective. Alongside eyelid surgery, including an upper eyelid lift, I offer treatments for dark circles, wrinkle treatment and facial contouring with hyaluronic acid or lipofilling using your own fat, as well as nanofat treatment. Where medically appropriate, these procedures can be performed during the same operation.
How important is aftercare to achieving a good surgical result?
Following my aftercare recommendations will support the healing process and help minimise conspicuous scarring. During the first few days after the procedure, it is important to rest and cool the treated area regularly. Avoiding creams and make-up during the first week also helps reduce the risk of impaired wound healing and pigment deposits in the scar, sometimes referred to as scar tattooing.
How does hyaluronic acid work?
Hyaluronic acid is a naturally occurring substance that is also produced by the body, although production gradually declines over time. It plays an important role in regulating moisture within the tissues, helping them retain volume, firmness and elasticity. In aesthetic medicine, hyaluronic acid is used as a filler to soften dark circles and wrinkles or to contour specific areas of the face.
What is lipofilling?
For lipofilling, also known as autologous fat transfer, fat cells are removed from another area of the body, carefully processed and then injected into the area of the face being treated. The technique can be used, for example, to soften wrinkles or enhance and shape the lips. Lipofilling is one of my specialist areas as a plastic and aesthetic surgeon. I began exploring the technique and its applications during my medical studies and subsequently developed this expertise further through my clinical work.
What is nanofat?
Nanofat is an innovative technique in plastic and aesthetic surgery. Rather than adding facial volume, its purpose is to improve skin quality over the longer term. Regenerative components of fatty tissue, including stem cells and growth factors, are isolated and injected into the upper layers of the skin using very fine cannulas. Nanofat can stimulate cell renewal and may be used for ageing or blemish-prone skin, dark circles, other unwanted pigmentation and scar treatment.
How important is aftercare to achieving a good surgical result?
Following my aftercare recommendations will support the healing process and help minimise conspicuous scarring. Immediately after surgery, it is important to rest, cool the treated area regularly and avoid exercise for at least three weeks. Avoiding creams and make-up during the first week also helps reduce the risk of impaired wound healing and pigment deposits in the scar, sometimes referred to as scar tattooing.
How should I prepare for a lower eyelid lift?
Above all, it is important to follow the pre-operative advice I provide. This includes avoiding painkillers, sleeping tablets and blood-thinning medication for at least one week before surgery, where medically appropriate. You should also avoid nicotine and alcohol if possible. Prescribed medication must never be discontinued without consulting the doctor responsible for your care.
Can I wear contact lenses immediately after an eyelid lift?
Your eyes will be too sensitive for contact lenses during the first week after surgery. Inserting and removing the lenses would also place unnecessary strain on the skin in the surgical area and could interfere with healing. I therefore ask you not to wear contact lenses until your sutures have been removed. At that appointment, I will advise whether you can resume wearing them immediately or should wait a few more days.
Who is suitable for an eyelid lift?
An eyelid lift may be suitable for patients who feel self-conscious about changes to the skin and tissue around or beneath their eyes. It can be performed as an upper eyelid lift, a lower eyelid lift or a combination of both.
Will I experience pain after the procedure?
Eyelid surgery is generally associated with relatively little pain. Many of my patients report being pain-free on the day of surgery. You may experience mild soreness during the first few days, for which our team will provide suitable pain relief and anti-inflammatory medication to use if required.
When can I go home after a lower eyelid lift?
An eyelid lift is normally performed as an outpatient procedure, so an overnight stay in hospital is generally neither required nor planned. After surgery, my patients rest for one to two hours in the clinic adjoining our practice before returning home. Important: if you have had a general anaesthetic, you must not drive yourself on the day of surgery.
Are there any contraindications?
Certain medical conditions, such as severe high blood pressure, poorly controlled diabetes mellitus and some autoimmune diseases, may make eyelid surgery inadvisable. The same applies if you take blood-thinning medication that cannot safely be discontinued. In such cases, the procedure may need to be postponed. During your consultation, I will assess whether there are any reasons why a lower eyelid lift should not be performed at the planned time.
Will health insurance cover the cost of a lower eyelid lift?
Health insurance will rarely cover the cost because a lower eyelid lift is usually considered a purely cosmetic procedure. Exceptions may apply when surgery is medically necessary, for example because of eyelid malposition.
How do I find the right surgeon for a lower eyelid lift?
It is important to know that the professional title “cosmetic surgeon” is not legally protected in Germany. The German titles “Arzt für plastisch-ästhetische Operationen” or “Facharzt für Plastische und Ästhetische Chirurgie” indicate that a doctor has completed several years of theoretical and practical specialist training in this field. Their practical experience in eyelid surgery is another important indication of their qualifications, so you should feel free to ask about this during your consultation. I began focusing increasingly on plastic and aesthetic surgery during my medical studies and continued to deepen my knowledge and practical expertise throughout my specialist training and clinical career.