Eyelid surgery in Amsterdam by a BIG-registered ophthalmologist

Eyelid surgery in Amsterdam, performed by an ophthalmologist with oculoplastic specialisation rather than a general cosmetic practice. Consultations are held in English — you do not need to speak Dutch.

What is eyelid surgery?

Eyelid surgery — medically a blepharoplasty — removes excess skin and, where needed, muscle or fatty tissue from the upper or lower eyelid. As skin loses elasticity with age it settles over the eyelid margin, a condition called dermatochalasis. In pronounced cases the skin hangs over the lashes and cuts into the upper part of your visual field.

The procedure restores both the function and the shape of the eyelid. Because the eyelid protects the eye and spreads the tear film across its surface, the margin between removing too little and too much is small. That is precisely why we have this performed only by an ophthalmologist.

Upper or lower eyelid?

These are two different operations, with their own technique, recovery and price.

Upper eyelid surgery

The most commonly performed. The incision sits in the natural eyelid crease and is barely visible once healed. This addresses hooded upper lids that create a tired look or restrict the visual field.

Lower eyelid surgery

Aimed at under-eye bags, protruding fat and excess skin. The incision runs just beneath the lash line or, in a transconjunctival approach, on the inside of the eyelid so no visible scar is left. This is the more demanding of the two: removing too much tissue can pull the lower lid outward.

Dermatochalasis or ptosis: what is the difference?

This is the central question of a first consultation, and the most commonly missed one.

• Dermatochalasis is a skin problem. There is too much skin over the eyelid margin, but the eyelid itself sits at the correct height. The answer is eyelid surgery.
• Ptosis is a muscle problem. The eyelid-lifting muscle, the levator palpebrae, is underperforming, so the eyelid margin itself sits too low. The answer is ptosis surgery.

The two frequently occur together. If only skin is removed while ptosis is also present, the eye still sits too closed afterwards and the result disappoints. We therefore measure the eyelid margin against the pupil reflex and assess levator strength before any treatment plan is made.

Medical or cosmetic?

The distinction determines whether reimbursement is even on the table.

Medical indication

When overhanging skin genuinely restricts the upper visual field. Patients describe difficulty reading, heavy or tired eyes by the end of the day, headaches from constantly raising the eyebrows, and unconsciously tilting the head back to see beneath the skin. Where a visual field restriction is suspected we carry out a visual field test, which records the limitation objectively.

Cosmetic indication

When heavy or hooded eyelids give a tired, older or stern impression without loss of function. A cosmetic procedure is a perfectly legitimate reason for treatment, but falls outside Dutch health insurance.

The procedure step by step

1. 1.Consultation and measurement. Dr. Kloos assesses eyelid position, excess skin, levator function and the tear film, and discusses what is and is not achievable. Where the question is medical, a visual field test follows.
2. 2.Marking. Immediately before surgery, how much skin will be removed is drawn while you are seated — sitting, because skin falls differently when lying down.
3. 3.Local anaesthesia. The eyelid is numbed locally. You stay awake and no general anaesthetic is needed, which substantially reduces the risks of the procedure.
4. 4.The correction. Excess skin is removed along the pre-marked line, together with a strip of muscle or fat where needed. The procedure takes 45 to 90 minutes.
5. 5.Closing. The eyelid is closed with a fine suture within the natural crease.
6. 6.Follow-up. Sutures come out after five to seven days, at a check with the treating ophthalmologist.

Recovery, week by week

• Day 0 to 2. Swelling and bruising are normal and at their worst in the first 48 hours. Cooling limits both. Sleep with your head slightly raised.
• Day 3 to 7. Swelling visibly subsides. Sutures are removed between day five and seven.
• Week 2 to 3. Bruising has largely gone. Most patients feel presentable again at this point. The scar is still pink.
• Week 4 to 6. The scar fades and pales. Sport and heavy lifting can resume.
• Month 3 to 6. The final result. The scar in the eyelid crease is usually hard to distinguish by then.

Plan two to ten days off depending on your work. Screen-based work is usually manageable after a week, client-facing work often after two.

Possible complications

Eyelid surgery is common and safe, but no operation is without risk. We discuss, among others: temporary dry or gritty eyes, minor asymmetry between the two sides, a tender or thickened scar, and very rarely a post-operative bleed. The risk of an underlying, unrecognised ptosis or an over-correction is exactly why this should be done by an ophthalmologist rather than in a general cosmetic practice.

What this costs, and insurance

Our prices are published and include consultation and follow-up. For upper eyelid surgery on both eyes you pay a fixed amount, with nothing added afterwards.

If you are new to the Dutch system: reimbursement comes from your health insurer, not from us, and only where a medical indication has been established. Your insurer assesses each case individually, usually on the basis of a visual field test and a referral from your GP (huisarts). A cosmetic procedure is never reimbursed. We set out how authorisation and billing work on our insurance and billing page.

Why an ophthalmologist rather than a cosmetic clinic?

Eyelid surgery is surgery on the eye, not merely on facial skin. Dr. Kloos is a BIG-registered ophthalmologist with oculoplastic specialisation — the field at the intersection of ophthalmology and reconstructive surgery.

BIG registration is the Dutch government register of qualified healthcare professionals; it is the legal standard here for practising medicine and confirms a verified, regulated qualification.

The difference is concrete. An ophthalmologist recognises an underlying ptosis before any incision is made. An ophthalmologist assesses the tear film and knows when removing skin will cause dry eye. An ophthalmologist knows the anatomy of the levator, the septum and the tear drainage system from daily clinical practice. And an ophthalmologist knows when not operating is the better answer.

Consultations in English, in Amsterdam

Skin & Vision Clinic is at Louwesweg 6k in Amsterdam, easily reached by car and by public transport. Consultations are conducted in English, and all patient information documents are available in English. You do not need to speak Dutch, and you do not need a referral for a cosmetic consultation — though you will need one from a GP if you intend to claim on insurance.