What I do as an Oculoplastic Surgeon
Oculoplastics is the field of plastic surgery of the eyelids, and is a highly specialised area. In the UK, eyelid surgery is mostly carried out by Oculoplastic surgeons. The reason for this is that the purpose of the eyelids is to protect the eyes.
Oculoplastic surgeons are fully trained Ophthalmologists (eye surgeons) who after at least 7 years training go on to specialise in eyelid plastic surgery. Surgery on the eyelids affects the eyes, and it is necessary to assess the eyes before eyelid surgery. This dual expertise is essential in protecting eye health and avoiding complications like dry eye, eyelid malposition, or difficulty closing the eyes after surgery.
Oculoplastics combines reconstructive and cosmetic techniques to treat the eyelids, tear ducts, eye socket, and surrounding facial anatomy.
Lacrimal surgery is the field within Oculoplastics covering the production and drainage of tears, which are intimately related to the eyelids. The lacrimal gland (tear gland) sits in the outer corner of the upper eyelids and produces tears. These tears drain into lacrimal canaliculi/sac/duct that sit in the inner corner of the eyelids.
What is the difference between an Oculoplastic Surgeon and a General Plastic Surgeon?
Although many plastic surgeons are competent at executing aesthetic eyelid surgery, they have no training in and are unable to examine the eye, understand eye disease, anticipate eye problems that may affect the surgical plan, or identify complications.
In contrast, Oculoplastic surgeons have training throughout several years in microsurgical ophthalmology followed by highly specialised training in the oculoplastics only. The status of the eye is key in the eyelid surgery planning.
Every year, I see patients who have gone to Turkey for surgery with a general plastic surgeon and can no longer closer their eyes. The problems of medical tourism have been brought before Government. See here and here. There is little protection or restitution if something goes wrong. It’s always wise to be careful if someone offers surgery without first carrying out a proper assessment.
The table below summarises some of these differences:
| Oculoplastic Surgeon | Plastic Surgeon | |
| Performs mainly eyelid surgery | ✔ | X |
| Performs facelifts, breast surgery, tummy tucks | X | ✔ |
| Trained to examine the eye | ✔ | X |
| Can identify pre-existing eye disease | ✔ | X |
| Can examine the eye postoperatively to ensure that there are no eye related complications | ✔ | X |
| Can manage any eye related postoperative complications if they arise | ✔ | X |
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