Upper Eyelid Surgery

As a result, the eye area can appear heavier or more tired, even though the underlying expression has not actually changed.

An upper eyelid lift therefore does not simply address excess skin. What matters is understanding which structures are responsible for the change, and how much can be corrected without altering the natural shape of the eye.

At Clinic Selnau in Zürich, we plan upper eyelid lifts with particular attention to individual eye shape, brow position, and a natural transition between the eyelid and the surrounding structures.

Our Approach

Every eye area is different.

Eye shape, eyelid crease, skin quality, fat distribution, bone structure and brow position all determine how the upper eyelid is perceived.

For this reason, planning an upper eyelid lift does not begin with the question of how much skin can be removed. Instead, we look at which changes have actually occurred in the upper eyelid, and which features are characteristic of your individual expression.

For some people, excess skin is the main concern. For others, descended brows, changes in fat tissue, or the natural anatomy of the eye socket have a greater influence on appearance. These differences are decisive for planning.

Eye Shape, Eyelid Crease & Expression

The natural shape of the eyes should not be redefined by an upper eyelid lift.

The eyelid crease, the visible eyelid surface and the transition to the brow exist in an individual relationship to one another. If this relationship is altered too significantly, personal expression can change as well.

An upper eyelid lift may be considered for changes including:

• Excess or lax skin on the upper eyelid
• A natural eyelid crease that is increasingly obscured
• A heavy or tired-looking gaze
• Excess skin extending toward the lash line
• Changes to the fat tissue of the upper eyelid
• Asymmetry between the two upper eyelids
• Age-related changes to the upper eye area
• Functional impairment caused by pronounced excess skin

Not every heavy-looking eye area, however, results from excess skin on the upper eyelid. Brow and forehead position can also play a decisive role. For this reason, it must be clarified before surgery at which anatomical level the visible change actually originates.

Planning & Analysis

Careful analysis is an essential part of every upper eyelid lift.

During consultation, we do not consider the two eyes in isolation, but in relation to the brows, forehead and the rest of the face.

We assess excess skin, the eyelid crease, fat tissue and any existing asymmetries. At the same time, we consider brow position and how it influences the amount of visible skin on the upper eyelid.

Your natural eye shape also plays a central role. The aim is not to create the same standardised eyelid shape across different eyes.

Standardised photography supports this analysis and helps us discuss the starting point and treatment goal together.

On this basis, we determine which structures should actually be treated and, equally important, which should be preserved.

The Procedure

In an upper eyelid lift, excess skin is removed in a targeted way. Depending on individual anatomy, small amounts of the underlying tissue or fat can also be addressed.

The extent of the correction is planned individually. Here, more removed skin does not automatically mean a better result. Preserving sufficient skin and tissue is important for natural eyelid closure, the function of the upper eyelid, and the characteristic shape of the eye area.

The incision is typically placed within the natural eyelid crease, so that the resulting scar sits as inconspicuously as possible when the eye is open.

Which additional structures are treated depends on the individual starting point. For some eyes, a skin correction alone is sufficient. For others, the distribution of fat tissue or the relationship between the upper eyelid and the brow needs greater consideration.

Upper Eyelid or Brow?

One of the most important questions before an upper eyelid lift is where the apparent excess skin actually comes from.

With age, it is not only the skin of the upper eyelid that can lose tension. The brow, too, can shift position and, as a result, push additional tissue down onto the eyelid.

If, in such a situation, only skin is removed from the upper eyelid, the actual cause may not be fully addressed. For this reason, we always assess brow position together with the upper eyelid.

Where a descended brow is the primary concern, a brow lift may be appropriate. Where the change affects the forehead and upper face more broadly, a forehead lift can be a different treatment option.

In some situations, different approaches can be combined. In others, an isolated upper eyelid lift is entirely sufficient. It is not the amount of visible skin that determines the treatment. What matters is why it is visible there.

Upper and Lower Eyelid as One Unit

The upper and lower eyelids together shape the eye area, yet they change in different ways.

The upper eyelid is often primarily affected by excess skin. The lower eyelid, by contrast, can be more strongly influenced by under-eye bags, changes in fat tissue, excess skin, or the transition between the lower eyelid and the cheek.

A lower eyelid lift therefore follows different anatomical principles than an upper eyelid lift.

Where changes exist in both the upper and lower eyelid, both areas can be assessed together and, where appropriate, treated within a single operation. This does not mean, however, that treating one area automatically requires correcting the other. What matters remains which changes are actually present, and which of these concern you.

Complementary Treatments

The eye area is closely connected to the rest of the face.

Where descended brows contribute significantly to the heavy appearance of the upper eyelids, a brow lift, or for more extensive changes a forehead lift, may be appropriate.

For patients not yet ready for surgery, botulinum toxin can temporarily soften the muscle activity around the brow, though its effect is more limited and short-lived than a surgical lift.

Volume loss in the temples, cheeks, or the transition between the lower eyelid and the cheek can be assessed independently. A fat transfer to the face can, in suitable situations, be used to address such volume changes.

For more pronounced changes in the mid and lower face, a facelift pursues a different goal. It addresses the position of deeper tissue layers and the contours of the cheeks and jawline, not the excess skin of the upper eyelid.

Combining several procedures is not automatically necessary. Planning is guided by which anatomical changes genuinely belong together.

Less Can Be More

The eye area responds particularly sensitively to change.

Removing too much skin or fat tissue can alter the natural shape of the upper eyelid and change the appearance of the gaze. What can technically be removed should therefore not automatically be removed.

The aim is not the largest possible visible eyelid surface. It is to reduce disruptive excess skin or tissue while preserving enough natural structure.

The eyes should appear more open and rested, without losing their characteristic shape.

A successful upper eyelid lift does not change your gaze. It lifts the weight from it.

Healing & Results

Swelling and bruising are normal in the first period after an upper eyelid lift.

They are usually most noticeable in the first few days and then gradually subside. Minor differences between the two sides can also occur during the early healing phase.

The scar sits within the natural eyelid crease and continues to change over the following weeks and months. At first it may appear slightly red or firm, before becoming increasingly inconspicuous.

As swelling decreases, the new contour of the upper eyelid becomes clearer. It takes time, however, for the tissue and scar to fully settle.

The natural ageing process continues even after an upper eyelid lift. Skin, brows and the surrounding structures will continue to change over the years.

The aim, therefore, is not a permanently fixed state, but a natural correction that can continue to develop harmoniously with the face.

Consultation

An upper eyelid lift begins with the question of which structures influence your expression today.

During your consultation at Clinic Selnau in Zürich, we assess your upper eyelids, the natural eyelid crease, existing excess skin and the distribution of fat tissue. At the same time, we consider the brows, forehead and the eye area as a whole.

We discuss which changes concern you, and which of these can meaningfully be addressed through an upper eyelid lift.

We also clarify whether the visible change genuinely originates in the upper eyelid, or whether brow position plays a significant part in it.

On this basis, a treatment plan is developed that is guided by your individual eye shape and anatomy.

We discuss openly what result can realistically be expected, which surgical approach makes sense, how the healing phase unfolds, and what limitations and risks need to be considered.

The aim is not to create a new eye shape. It is to open the eye area and give it more lightness, while your personal expression is preserved.