Heavy upper lids make a man look tired long before he feels it. The operation is the same one women have — the planning is not, because a man's brow sits lower and has to stay there.
Please note: A medical consultation is a chargeable service under the German physicians’ fee schedule (GOÄ). Online bookings are binding; the practice team will explain the expected consultation fee when arranging your appointment.
Medically reviewed by Dr. med. Juliane C. Finke and Dr. med. Stephan Frantzen · Board-certified plastic surgeons · Last reviewed:
Eyelid surgery — medically a blepharoplasty — removes excess skin and, where required, muscle and fat from the upper or lower lid. The aim is an open, rested look, not a changed expression.
Upper lid skin is the thinnest on the body and it gives way first. When it does, it folds over the lid crease, and in more pronounced cases rests on the lashes. What patients describe is rarely „I look old"; it is „people keep asking if I slept badly", and „my eyeshadow disappears into the fold".
The operation removes a precisely measured strip of skin along the natural crease, sometimes with a small fat pad near the nose. The scar lies in the crease and is invisible with the eye open.
The lower lid is the more delicate of the two, and the finding matters more than on the upper lid because the treatments differ:
Removing too much from a lower lid is the classic error in this operation — it pulls the lid margin down and gives a rounded, staring look. We are deliberately conservative here, and we would rather do slightly too little.
From the starting point through the incision to the course of the scar.
You are marked up sitting upright, with your eyes open and closed — how much skin is genuinely excess can only be judged in that position. The area is then numbed with local anaesthetic; you are awake and can follow what is happening.
Upper and lower lids together take about 90 minutes, one lid alone 45 to 60. Fine sutures close the incisions, and cooling starts immediately.
You rest at the practice for a while and go home the same day. We see you the very next morning for a wound check, and you have a number to call around the clock in the first days.
Swelling and bruising are at their most obvious on days two and three, then fade quickly. Cooling in the first 48 hours makes a real difference. Sutures come out after about seven days.
Expect dry, gritty eyes and slightly blurred vision in the first days — the lids are swollen and blink less completely than usual. We send you home with lubricating drops.
Most people are presentable with make-up after a week to ten days. The scar is pink for a few months and then becomes very hard to find, particularly on the upper lid.
Sometimes — and this is one of the few aesthetic procedures where that is genuinely true. If excess skin hangs far enough to restrict your field of vision, the operation is functional rather than cosmetic.
The proof required is an ophthalmologist's visual field test, once with the lid in its natural position and once with the skin taped up. If the difference is significant, an application to a German statutory insurer has a realistic chance. We provide the surgical report and photographs; your ophthalmologist provides the measurement.
Lower lid surgery is essentially always aesthetic and is paid privately. If you are insured outside Germany, check your policy before you travel — most international policies exclude both.
Possible complications include bleeding, infection, dry or irritated eyes, asymmetry, visible scars, altered sensation, difficulty closing the eye, lid malposition and the need for revision. Bleeding behind the eye is rare but can threaten vision; sudden severe pain, rapidly increasing swelling or impaired vision requires immediate emergency assessment.
| How long | 45–90 minutes – one lid 45 to 60, both about 90 |
|---|---|
| Anaesthetic | Local anaesthetic – you are awake |
| Stay | Day surgery – home the same day |
| Sutures | Out after 7 days, wound check the next morning |
| Back to work | About a week, presentable with make-up after 7–10 days |
| Scar | Upper lid: in the natural crease. Lower lid: just below the lash line |
| Where | Day surgery at our practice, Heinrich-Roller-Straße 15, Berlin-Prenzlauer Berg |
| Paid by | Private fee – upper lid possibly covered where the visual field is restricted |
What does eyelid surgery cost? There is no flat rate. Time in theatre, technique, anaesthetic and the extent of the procedure differ from person to person. You get a binding quote at the end of your consultation — in writing, with nothing hidden.
Will insurance pay? As a rule, no: purely aesthetic procedures are paid privately. German statutory insurers only contribute where a medical indication is recognised; private insurers and international policies decide case by case. We will tell you honestly whether you have any prospect of cover. For the upper lid specifically, an ophthalmologist's visual field test can establish a functional indication. And the consultation itself? Medical advice is a treatment in its own right and is invoiced under the German scale of medical fees (GOÄ) — including when you decide against a procedure afterwards. We tell you what to expect when the appointment is made.
These points apply generally. What applies in your case – with existing conditions or regular medication – we go through at your pre-operative consultation. That conversation is what counts.
Not every tired-looking eye area needs an operation. We look first at whether something smaller would do the job – and we will say so if none of these procedures fits your finding.
The technique is the same as in a woman — the measurement is not. Three differences drive the planning.
The brow sits lower. In men the eyebrow typically runs along or just below the bony orbital rim; in women it sits above it. Take too much skin from the upper lid and the brow travels upwards — and the face is feminised immediately. We therefore plan conservatively in men and would rather leave a millimetre standing.
The skin is thicker and better supplied with blood. Male skin has a sturdier dermis and more vessels. In practice that means slightly more bleeding during the procedure and slightly more swelling in the first days — but the scars are often less conspicuous, because thicker skin heals more finely.
Beard growth on the lower lid. Where an incision below the lash line runs into the beard, the placement is chosen so that shaving stays straightforward afterwards.
All of this is discussed in the practice's dedicated men's clinic — a consultation slot reserved for male patients, where the subject can be raised without an audience.
Board-certified plastic surgeon and
board-certified general surgeon
Board-certified plastic surgeon (plastic &
aesthetic surgery), Fellow of EBOPRAS
Dr. Juliane C. Finke and Dr. Stephan Frantzen are full members of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC) and the German Society of Senology (DGS). Dr. Finke is also a Fellow of EBOPRAS and passed the European board examination in 2010; Dr. Frantzen operates on a voluntary basis for INTERPLAST in South America. The jameda seals lead to the independent physician profiles with patient reviews of Dr. Finke and Dr. Frantzen.
Medically reviewed by Dr. Juliane C. Finke and Dr. Stephan Frantzen
No, if the right amount is removed. That is precisely why we mark you sitting upright with your eyes open — the amount of genuinely excess skin cannot be judged lying down. Removing too much is what produces a surprised or staring look, and it is far easier to avoid than to correct.
The injection of local anaesthetic stings for a few seconds. After that you feel pressure and movement, not pain. Afterwards, ordinary painkillers are enough for almost everyone — most people describe it as tight rather than sore.
Most obvious on days two and three, largely gone by day seven to ten. Sunglasses cover a great deal in the meantime, and make-up is allowed once the sutures are out.
Reading from day two or three in short spells. Screen work is usually manageable after three or four days, but your eyes will be dry and will tire faster — use the lubricating drops liberally.
After about two weeks, once the swelling has settled. Glasses from the start.
Many years — an upper lid correction commonly lasts ten to fifteen. The skin continues to age, but it starts again from a much better position.
Possibly, for the upper lid, if an ophthalmologist's visual field test shows that the excess skin measurably restricts your vision. Lower lid surgery is aesthetic and is paid privately.
Yes, and it is common — about 90 minutes in total, one recovery instead of two.
Common and temporary: swelling, bruising, dry eyes, blurred vision for a few days. Less common: asymmetry, visible scarring, or on the lower lid a slight downward pull of the lid margin. Rare: infection, or an incomplete lid closure — which is why we err on the side of removing too little.
Book an appointment in the men's clinic. We mark you sitting upright, show you how much skin is genuinely excess, and tell you if the answer is less than you expected.
Related treatments: Wrinkle treatment · Thread lift · Facelift · Facial treatments · For women
Medically reviewed by Dr. Juliane C. Finke, board-certified plastic surgeon (plastic, reconstructive and aesthetic surgery), and Dr. Stephan Frantzen, board-certified plastic surgeon and board-certified general surgeon.
Last medically reviewed:
The content of this page is for general information and does not replace medical advice. A binding assessment is only possible after a personal examination.
Independent information: The German Society of Plastic, Reconstructive and Aesthetic Surgeons provides patient information on choosing a specialist, consent, limitations and possible complications. The German Medical Association explains the GOÄ fee schedule. These German-language sources supplement, but do not replace, an individual medical examination.
