Upper Eyelid Surgery (Blepharoplasty)

Upper eyelid blepharoplasty at M-Gate klinika uses a proprietary microsurgical technique that MUDr. Jan Tišer describes as unique in the Czech Republic and performed at only a small number of European and US clinics. The approach removes drooping skin from the upper eyelid while strategically preserving the periorbital fat pad rather than removing it wholesale — a decision that prevents the hollowed, over-operated look that can result from less nuanced techniques. Surgery takes place under local anaesthesia only on an outpatient basis; there is no general anaesthetic and no hospitalisation. MUDr. Tišer has applied this method to more than 3,000 patients since 2008 and maintains what the clinic describes as the largest authentic before-and-after case series in the country. Results are considered stable and definitive at six months. The clinic's ZnamýLékař rating of 5 out of 5 across 91 verified reviews reflects consistently high patient satisfaction with both the outcome and the experience.

Upper eyelid ptosis — the downward descent of the upper eyelid skin caused by stretching of the orbicularis muscle, loss of skin elasticity and redistribution of the periorbital fat pad — is one of the most common aesthetic concerns in adults from the mid-thirties onwards. Beyond the cosmetic aspect, significant skin excess can encroach on the visual field and cause practical difficulties with reading or driving. Blepharoplasty addresses both dimensions by surgically removing the redundant tissue, restoring a more alert, rested appearance and, where relevant, restoring the full visual field. At M-Gate klinika MUDr. Jan Tišer takes the entire face as the reference frame for eyelid surgery rather than treating the lid in isolation. In the pre-operative consultation he assesses the distribution of skin excess, the quality and position of the brow, the volume and distribution of the periorbital fat pad, and the degree of muscle laxity contributing to the ptosis. This assessment determines the precise volume of skin to remove and whether any fat redistribution — rather than simple removal — will produce a more natural, age-appropriate result. The technique MUDr. Tišer employs preserves strategic portions of the fat pad to avoid the skeletonised appearance that older textbook techniques can produce; this is the element he identifies as technically distinctive from standard blepharoplasty performed elsewhere in the Czech Republic. The procedure begins with the patient in a reclined chair in the operating room. Local anaesthetic is injected along the planned incision line, and the patient remains awake and comfortable throughout. The incision is placed within the natural upper eyelid crease — the primary scar will be hidden within this fold when the eye is open. Excess skin is precisely excised and the subcutaneous tissue is addressed according to the operative plan. Microsurgical instruments allow fine control at every step. Sutures are placed to close the incision and the procedure for both eyelids is typically complete within 60 to 90 minutes. Recovery follows a predictable sequence. Swelling and bruising are most prominent in the first three days and are a normal part of the healing response. Patients are advised to avoid bending or leaning forward until suture removal, which takes place at days five to six. After suture removal, most patients can resume social activities; bruising typically resolves within two to three weeks. Physical exertion and exercise should be postponed until one week after suture removal. The scar continues to whiten and fade over two to nine months; definitive results are considered stable at the six-month mark. Preparation requires stopping blood-thinning medications such as aspirin (Anopyrin) and ibuprofen in advance of surgery, disclosing any allergies particularly to local anaesthetic agents, eating and drinking normally before the procedure, and bringing an adult companion to accompany the patient home. MUDr. Tišer advises against unauthorised application of scar massage or ointments during healing and requests that all post-operative care follow the specific instructions provided at the time of suture removal. This blepharoplasty is suitable for adults of any age experiencing either aesthetic dissatisfaction with drooping upper eyelid skin or functional vision impairment from skin encroaching on the visual field. Suitability for each individual is confirmed at the consultation; MUDr. Tišer takes a case-by-case approach to contraindications. The clinic offers this procedure without general anaesthesia, which removes the risks and recovery burden associated with sedation and makes it accessible to patients for whom general anaesthetic would be inadvisable.