Wanting to soften his appearance and make his eyes look more alert, he began researching plastic surgery in London to find out which surgery would be right for him. After some consideration he decided to schedule a consultation with one of a top facial cosmetic surgeon to discuss eyelid surgery.

During his consultation, Dr De Silva examined his eyelids and recommended that he undergo upper-eyelid surgery to treat the sagging skin above his eyes. For this surgery, his surgeon would remove the excess skin and fatty bag-like deposits below his eyes as necessary (termed dermatochalasis). He underwent hidden incision eyelid surgery (Transconjunctival Blepharoplasty) with a muscle sling for eyelid support (Orbicularis Oculi Sling). Dr De Silva tightened the muscles below the surface to create a firmer, more youthful look (Canthopexy). As an alternative to more traditional techniques, his surgeon would use the most modern innovation in eyelid surgery to preserve some of the fat and prevent hollowing of the eyelids (termed Fat Preservation Technique), older techniques result in removal of all the fat which that causes a hollowed aged and un-natural look. Dr De Silva uses the most up-to-date and best practice techniques to give Natural-Looking-Results, from experience acquired in New York and Los Angeles.

Review of his photograph shows lower eyelid bags with sunken cheeks (negative vector). Dr De Silva performed trans-conjunctival (hidden incision) lower blepharoplasty with canthopexy (lower eyelid support). Important considerations in this case is that in a young person, some fat should be transposed and preserved to avoid hollowness, conservative surgery is advised to give patients natural looking results. The ‘after’ photograph shows an absence of fat bags and a smoothened contour between his eyelid and cheek associated with youth.

Lower eyelid bags in this younger person was a result of the anatomical position of his eyelids in a relatively forward position in relation to his cheek, referred to as negative vector. Dr De Silva performed trans-conjunctival (hidden incision) lower blepharoplasty with canthopexy (lower eyelid support). In addition the man had sustained an fracture of the floor of his left orbit that had resulted in mild asymmetry and scarring. Important considerations in this case is that in a young person, some fat should be transposed and preserved to avoid hollowness, conservative surgery is advised to give patients natural looking results. The ‘after’ photograph shows the appearance of the eyelids at 5-weeks after surgery and shows an absence of fat bags and a smoothened contour between his eyelid and cheek associated with youth. There are no incision in the skin and no clinical signs of surgery resulting in a completely natural looking result. The patient was very happy with the resulting appearance.

The reviewed photograph shows marked changes associated with facial ageing including rolls of skin and muscle on the upper eyelids. The lower eyelids show fat bags, with a dark circle depression below the eyelid and marked wrinkling in the skin as a consequence of skin laxity. Dr De Silva performed upper blepharoplasty hiding the incision in the patient’s natural skin crease with a conservative reduction of the excess skin, muscle and fat. In the lower eyelid, transconjunctival (hidden incision) lower blepharoplasty with fat transfer to reduce the dark circles and hollowness. Finally skin resurfacing was completed to smoothen the surface of the skin rejuvenating the patient’s appearance. In the ‘after’ photograph the patient has a more youthful appearance, the eyelids have an increased upper eyelid show and the lower eyelids are smooth with an absence of bags, dark circles and wrinkles. The patient was very happy with the results as the appearance was natural with no clinical signs of surgery.