Dermatochalasis (Drooping Eyelids)

Drooping eyelids are a result of excess skin on the upper eyelid, thanks to skin losing elasticity over the course of the aging process. In rare cases, inflammation can cause this to occur in children, a process called “blepharochalasis”. It is treated in the same way in both cases.

Male and female eyelids

The upper eyelids of men and woman are different by nature. These differences are easily recognized by the experienced eye and we take these into account when performing the surgery. The picture shows the upper eyelid of a 30-year-old woman and a 30-year-old man.

Female

Male

The most important feature in both sexes is the eyelid furrow, which is formed by the uniform irradiation of the fibers of the levator aponeurosis (tendons) into the tarsus (a dense piece of connective tissue in the eyelid). In women, this usually lies at a height of 8-10 mm above the upper lid edge. On the other hand, in men, the eyelid furrow is set much lower, only 6-8 mm above the upper lid edge.

There are clear differences between the upper eyelids of men and women. A male upper lid typically has more skin excess than a female upper lid. This surplus should not always be completely removed: in men, we usually leave a certain excess on the upper lid in order to preserve the natural ‘male’ aspect of the lid.

Preserving your self-image

There are an infinite number of slightly different upper eyelid shapes – and the one we aim for requires a lot of consideration before the procedure. Normally, we aim to restore the eyelid shape that people had in early adulthood.

Some patients show no excess eyelid skin at a young age and, accordingly, more tissue should be removed from such patients. In other words, what represents a “normal” amount of tissue to be removed for one patient may already be too much for another patient. 

On the following pages, you can see from “before – after” pictures that are individually different: in some patients, we remove only a little excess, in others more, so that the result corresponds to the patient’s self-image of years ago.

The consideration of these elementary differences is a matter of course for us and for this reason we also ask you to bring older portraits for the first meeting.

52 years old

18 years old

The illustration shows a patient aged 52 and 18 years. It is noticeable that in this man already in the teenage years a clear skin surplus, so a small amount eyelid droop existed. In this case, only a little amount of skin and fat excess should be removed to restore the patient’s self-image.
 

The operation

Upper lid blepharoplasty can be performed on an outpatient basis under local anesthesia. The procedure can usually be performed on both eyelids in the same session and takes about 30 minutes.

Before the actual procedure, we decide on the cut that should lead to the optimal result. With a pen, we draw a precise sketch on the skin. The excess skin and a fine muscle strip are delicately removed in with a scalpel using extreme care. If there is also an excess (or an unexpected distribution) of fatty tissue, this will also be corrected. Finally, the skin is closed with a fine continuous suture.

The so-called “intracutanous suture” is deliberately omitted. In other dermatological procedures, this approach can bring many benefits, but this is not the case with the upper eyelid: there’s no benefit in terms of scar appearance, and it’s also mechanically less resilient too.

The procedure takes about 45 minutes, and upper eyelid blepharoplasty can also be combined with removal of the bags under the lower eyelid (blepharoplasty).

The upper eyelid blepharoplasty can also be combined with removal of the bags under the eyelid (blepharoplasty).
 

Our Results

Dermatochalasis-female-1a
Before
Dermatochalasis-female-1b
After
Dermatochalasis-female-2a
Before
Dermatochalasis-female-2b
After
Dermatochalasis-female-3a
Before
Dermatochalasis-female-3b
After
Dermatochalasis-female-4b
Before
Dermatochalasis-female-4a
After
Dermatochalasis-male-1a
Before
Dermatochalasis-male-1b
After
Dermatochalasis-male-2a
Before
Dermatochalasis-male-2b
After
Dermatochalasis-male-3a
Before
Dermatochalasis-male-3b
After
Dermatochalasis-male-4a
Before
Dermatochalasis-male-4b
After

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Augeninstitut ELZA
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Great team and service!
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Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
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Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
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Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
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Augeninstitut ELZA
4.7
Based on 74 reviews
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