Frequent asked questions

What makes surgery successful, is its personalisation. All patients and all looks are different.
There is no “eyelid surgery”. But multiple eyelid surgeries. AND above all, YOUR eyelid surgery.
With this type of surgery, I cannot know what needs doing without having asked you questions, without having examined you, 
as there are so many variables, which are difficult to explain by simple exchange of letters:

- your state of health
- your current treatments, in particular those which thin the blood
- your lifestyle, do you smoke? Do you do a lot of sport?
- your quality of sleep, your sleeping position
- your allergies and medical intolerances
- your ocular, palpebral history
- do you have dry or watery eyes? Do you work in front of a screen? In an air conditioned atmosphere? Outdoors?
- have you already had an operation? Of the eyes? Of the eyelids?
- have you already had aesthetic treatment? In particular around the eyes? Do you know what was injected?
- the shape of your eye sockets, your eyes, your eyelids
- is the problem recent, or old? Do you have photos of yourself when you were younger?
- the shape/state of the rim, the cartilage and tendons in your eyelids
- the muscular function of your eyelids, on opening and closing
- eye mobility
- skin quality, its smoothness, its elasticity, its colour
- presence or not of shadow, hollow/sunken, bluish, purplish, orangey, brown
- presence or not of fatty pockets
- presence of swelling, oedema, circulatory problems
- the appearance of the rest of the face, in particular the brow, temples, eyebrows, cheeks
- do you think you would be able to undergo the operation with a local anaesthetic?
- do you think you could tolerate a dressing which closes the eyes? Several hours? Overnight? Longer?
- could you tolerate post-operative discomfort, eyes which sting, which run, misty vision?
- would you be able to take time off work, one week, ten days, fifteen days?
- could you deprive yourself of the sun for 2 months? 6 months?
- are you able to accept the limits of surgery and admit the risks?

If you think about eyelid surgery, first of all think about a consultation. Face to face, we will have the time to carefully analyse your situation, to judge your wishes and to debate at length all possibilities for improvement, medical, technical, surgical...

I work entirely in the private sector. The price of a consultation varies between 40 and 80 euro, which you are able to pay in cash, by bank card or by bank transfer.
When the reason for a consultation is (at least partially) medical, at the university hospital there is the possibility of a repayment of fifteen euro from your mutual insurance.

Usually, surgery of the upper eyelid consists of resectioning the excess skin which weighs on the lashes and which is called “dermatochalasis” or “hood”.
Sometimes, independently of the skin, the eyelid droops as the muscle which is there to lift it up (for example, when you look up) is deficient.
Whether it has always been like that (congenital ptosis), linked to a neurological or muscle disease, or mechanical failure of the muscle (after an accident, related to daily handling of contact lenses, or simply due to age...).
Ptosis correction is not done by resectioning the skin, but by reinforcing the muscle, situated deeper inside the eyelid.
Even if this is performed under local anaesthetic, and as an outpatient, muscle surgery is more delicate.
A muscle that has been operated on requires a short period of convalescence, or re-education. Its recovery being slightly fluctuating, the surgical result is not always precise to the nearest millimetre as that of a simple resection of the skin.

When the eyelids are a bit heavy, a “reflex” compensation by contraction of the brow muscle lifts the eyebrows to render the palpebral weight more supportable. This contraction of the brow may be responsible for wrinkles, and even headaches.
If treatment by botulinum toxin (Botox®) is performed on the brow, the brow relaxes, the wrinkles disappear, and perhaps the headaches, but the eyebrows are going to descend, and with it, the eyelids, which will become heavier.
The ideal therefore, is to start with the toxin treatment on the brow muscle then reduce the weight of the eyelids by surgery, once the brow has relaxed. The surgical dimensioning will be better for it.

The final price of eyelid surgery depends on the technique chosen, the possible complementary acts performed, choice of anaesthetic, duration of hospital stay... It can only be defined accurately after consultation.

The cost of upper blepharoplasty for simple excess of skin, under local anaesthetic and as out-patient at the Sart Tilman Hospital
starts at 1650 euro, including room, pharmacy, surgical and hospital fees,
to which must usually be added 21% VAT, i.e. a total of about 2000 euro all inclusive.

The possibility of partial reimbursement of the fees by your mutual insurance may be envisaged if the skin of the eyelids 
- weighs on the lashes, over the entire length of the eyelid
- reduces the pupillary area in a photo
- is responsible for reducing your field of vision in the central 30°
When these three conditions appear to be fulfilled in consultation, a “notification” dossier including photographs and field of vision results
is transmitted to the medical council who have one month to respond.
If the response is positive, part of the cost is taken care of.
Being entirely private, additional fees of about 1200 euro remain nevertheless applicable.

Eyelid bags are often due to the release of the fibrous support called “septum” which should retain the normal orbital fat around the eye.
The fat, which is no longer held back moves forwards and down, becoming more perceptible under the skin as the cheek below is hollow.
This is a story about contours: a bag above a hollow is more visible than a bag without the hollow.
The “old” surgery consisted simply of resectioning the fat, but generating an unfortunate shadow.
Certain new techniques allow us to move the fat from the bag towards the hollow and to tighten the fibrous support for a result which is much more aesthetic.
The result is better, but these surgeries have greater consequences, the convalescence much longer and distressing.
When this is not indicated or the patient is not ready to go ahead, it is often possible to mark time by simply filling the hollow, under the bag, by means of a small amount of hyaluronic acid. This is a gesture that can be performed during consultation. Rapid, not very painful, the effect of which is practically immediate and one that requires no convalescence period.

The white under the eye can be seen for a multitude of reasons.
Often because one has large expressive eye, whereas others have small deep-set eyes.
Seeing the white under the eye does not always merit any treatment.
If the eyelids are slightly distended, or their attachment is a bit sad, they may effectively be retightened, relifted.
Canthoplasty is to say “modification to the corner of the eyelid”.
Cantopexy (which is a type of canthoplasty) is fixing the corner of the eyelid, generally to the bone surrounding the eye.
These surgical operations may be “isolated”, but more often, are associated with other acts which are part of a more complete treatment.
For example, it may be useful to round out flat cheeks.
Sometimes, it is the eye that pushes the eyelid. A bit like a big stomach that pushes the belt, it is difficult to pull up.
In this context, it may be that other strategies are proposed. A bit like braces, or a diet... Obviously a way of talking.

The final price of eyelid surgery depends on the technique chosen, the possible complementary acts performed, choice of anaesthetic, duration of hospital stay... In particular, the cost of a lower blepharoplasty is very variable and can only be defined accurately after consultation.

Reducing fatty bags by the internal edge, under local anaesthetic, as an outpatient,
starts at 2000 euro, including room, pharmacy, surgical and hospital fees,
to which must usually be added 21% VAT, i.e. A total of about 2400 euro all inclusive.

The cost of a lower eyelid lifting, including smoothing out the fatty bags in the deep through (septo-fat transposition), retensioning the muscles (obicularis flap) sometimes the tendon in the lower eyelid (canthopexy) and skin re-modelling (cutaneous plasty), under general anaesthetic for 2.30 hours with overnight stay in hospital is about 4200 euro,
to which must usually be added 21% VAT, i.e. a total of about 5000 euro all inclusive.

Occasionally, a medical motive (lashes which rub the eye, eyelid separated from the eye, retractile scar...) may lead to partial reimbursement by your mutual assurance.

Surgery on the 4 eyelids is sometimes envisaged in order to only have one convalescent period away from work.
Combining the surgery of the 4 eyelids reduces the hospital costs by 300 euro (only one hospital stay instead of two), and in addition to this you will benefit from a slight reduction in fees. This requires total operating time greater than 2 hours, which you must be able to support under local anaesthetic.
Often, a sedative or general anaesthetic is better for surgery as long as this, which negates any financial benefit of a unique hospital stay as the fees for anaesthesia are superior to the aforementioned economies.
Obviously, it is more interesting to operate on the 4 eyelids the same day when a general anaesthetic is required.

I hold consultations on Tuesday mornings and perform surgeries on Wednesday mornings (sometimes on other days) at the CHU du Sart Tilman in Liège. You can find all the information about the university hospital at http://www.chuliege.be. Appointments for consultations can be made by phone at 04/3668880.

I also have a private clinic, Les Terrasses de l'Héliport, located at Bd Frère Orban 45/41 in Liège, dedicated to my aesthetic practice. I hold consultations there (pre- and postoperative consultations for aesthetic surgeries, aesthetic medicine for the eye area). I also perform minor aesthetic surgeries (non-reimbursable blepharoplasties) under local anesthesia for healthy patients. Appointments can be made directly by clicking the button at the top of the page.

Unfortunately, I have to admit to running late with consultations, depending on emergencies and necessities. I ask that you contact my secretary by telephone one hour before the appointment in order to confirm the time and avoid waiting for too long in the waiting room.

I operate for half of my time. Therefore, I have available a number of operating times.
The delay for operations of more than 2 hours is about 2 months.
It may be sooner for shorter operations, knowing that modifications to programs are frequent.

It is preferable to avoid the sun during the month before the operation in order to avoid stimulation of the pigmentation.
The scar from the upper eyelid is covered in the fold and is not, therefore, very exposed. You should just avoid resting with the eyes closed on a sunny terrace...
On the other hand, surgery to the lower eyelid is more exposed and requires greater precautions as long as it is slightly inflamed, sometimes up to 6 months. Sunglasses and sun cream are essential for the sun.

I do operate during the summer, if patients, knowingly, wish me to do so, (students, teachers). But obviously, it is more comfortable to have the operation in October than in August.

Post-operative evolution depends very much on the surgery performed, but also on your state of health, whether you smoke or not, whether you have fluid blood or not, whether you support a dressing which compresses the eyelids, eyes closed overnight or not...

Certain patients have no bruising, others remain blue for two weeks...

The usual evolution may be roughly summarised as follows:
6-9 days to remove stitches
10-15 days rest / break in socio-professional life is advised, not only for your comfort but also for a better surgical result.
It is important to note that in case of purely aesthetic surgery, no medical certificate is issued.
6-8 weeks to be presentable on a group photograph, at half distance ( weddings, communion, family party...)
At this stage the edges of the eyelids are still slightly oedematous, especially in the morning, the lashes have still not recovered all their sensitivity, the scars are still pink, blinking is still slightly “creased”(stiff eyelids), the eyes irritated, more watery than before.
Generally, it is 6 months before you no longer feel the presence of the scar and forget about the surgery.