Eyelid correction is generally a procedure that can be carried out on an outpatient basis if there is no increased risk of surgery or anaesthesia. An increased risk of surgery can be given, for example, if there is an increased tendency to bleed or high blood pressure, and an increased risk of anaesthesia if there are accompanying diseases such as cardiovascular disorders or diabetes.

Local anaesthesia is particularly recommended for outpatient operations, but the patient can also be discharged after a general anaesthetic. In this case, however, particularly high demands are placed on the possibility of complete accompaniment and observation of the patient.

If the upper eyelid is corrected only, the procedure can be outpatient. The situation is different with upper and lower eyelid plastic surgery or lower eyelid surgery alone: Here, the in-patient stay has the advantage of immediately recognizing and treating a possible eyelid malposition with protruding lower eyelid. In addition, the initial handicap of the patient in everyday life is naturally greater when all four eyelids are corrected, and the relief provided by nurses is also greater.

Outpatient surgery almost exclusively for operations under local anaesthetic with or without twilight sleep
The surgeon must have the possibility of outpatient surgery
The distance from home to the outpatient clinic must not be too great, so that the patient can receive help within a maximum of half an hour in case of complications
You have someone who can drive/care for you for 1 – 2 days, because 24 hours after the operation no vehicle may be driven

You save the costs of a hotel or clinic stay
After the operation you will return to a familiar atmosphere, which you can arrange according to your own taste

You will be completely taken care of, you do not need to worry about anything and you will be in the hands of experienced personnel

Immediate reaction is possible in case of complications

You will not be left alone with uncertainties as to whether an appearance after the operation is normal or an indication of a complication

You will be reminded of the measures to be taken to ensure correct follow-up treatment

Generally you’re going to be able to go home after approx. 1 – 2 days

The scars are mostly inconspicuous in the eyelid crease. Excess scar tissue (= keloids) does not form on the eye.

It takes about 6 months until the operation scar has changed into an inconspicuous light line. It is part of the surgical art to hide this scar on the upper eyelid exactly in the eyelid crease. However, it can protrude a few millimetres laterally over the skin fold.

On the lower eyelid, the scar follows the edge of the lower lid and is also inconspicuous here. If bags under the eyes of younger patients are operated on from the inner lower eyelid, there is no visible scar at all.

However, if the fresh scar becomes inflamed, there is a risk that the tissue will remain reddened for a longer period of time and may also thicken. An infection can never be ruled out with complete certainty.

If there is a tendency to excessive scarring (= keloid formation), scars on other parts of the body become wide and bulging: this is never observed on the eyelids, however.

Local anaesthesia with twilight sleep is the least stressful and allows the patient to cooperate during the lower eyelid surgery.

The general anaesthesia corresponds to an artificial coma, so to speak, in which not only the consciousness but also important reflexes are partly switched off. Respiration, heart and circulation are strictly controlled, a breathing tube in the trachea ensures that oxygen reliably reaches the lungs.

The advantage is that the patient is reliably unaware of the intervention. He falls asleep in the anteroom of the operating theatre and only wakes up again in the recovery room or even in his room.

The disadvantage is that the general anaesthesia deeply interferes with the body’s own regulation and in parts even puts it out of action. Thus, the patient’s own breathing and protective reflexes (e.g. cough reflex) are damped or even switched off. The anaesthetic risk is therefore higher with general anaesthesia than with local anaesthesia, which is preferred for eyelid correction (also for other reasons).

Twilight sleep with local anaesthesia

Twilight sleep with local anaesthesia of the operating area is less complex than general anaesthesia and carries less risk. You will first be injected by the anaesthetist via an intravenous cannula with an agent that makes you tired and very relaxed. It takes effect within minutes. The surgeon then injects a local anaesthetic into the nerve branches that supply the eyelids and into the operated eyelid itself in order to anaesthetize the entire area supplied by nerves.

The effect takes place within minutes and lasts for several hours, depending on the substance used, beyond the duration of the surgery. This is another advantage over general anaesthesia.

When operating on the lower eyelid, the cooperation of the patient is important. In order to estimate exactly how much tissue may be removed, the patient is often asked to look up towards the end of the operation. This is not possible under general anaesthesia, so this is another advantage of local anaesthesia. The patient can easily be awakened from twilight sleep for this assistance.

Twilight sleep with local anaesthesia is the procedure that the surgeon clearly prefers and offers you greater security, also with regard to the success of the surgery.

The surgery is basically painless, no matter which type of anaesthetic is chosen.

The local anaesthesia is combined with the so-called twilight sleep. It is induced by medication that calms down, makes you tired and creates distance to the event. After you have received this medication, the injection of the locally acting anaesthetic is first administered. Even if the patient does not fall asleep deeply, the procedure does not burden him or her and he or she can be awakened and asked to cooperate if necessary. Cooperation” here means, for example, moving the eyelids or the eyeball in a certain direction.

Under general anesthesia, the entire procedure is slept through. On the morning of the operation you will receive a preparatory sedative medication. After the anaesthesia you will be very tired for a long time, sometimes the newly operated patients complain about nausea.

After the surgery, pain may occur, but it is usually mild. Cooling relieves this pain quite reliably. If necessary, the surgeon can be given painkillers, which the anaesthetist writes down. However, these are only rarely used.