What is Oculoplastic Surgery?

The term oculoplastic surgery (sometimes called ophthalmic plastic reconstructive surgery or oculofacial surgery) describes the specialised branch of plastic surgery of the facial structures around the eye and includes both reconstructive and cosmetic (aesthetic) surgery.

Eyes, Eyelids, Face and almost nothing else!

Oculoplastic surgeons are specifically trained in both ophthalmology (eye surgery) and plastic surgery for the eyelid region of the face. They therefore become expert with eye conditions and their management. Unlike general plastic surgeons, oculoplastic surgeons do not offer surgery on any other parts of the body e.g. breast augmentation.

Since oculoplastic surgeons only deal with problems of this area, they treat the largest number of cases in this region and are therefore the most familiar with the specialised anatomy and physiology of the eyelid region and its relationship to the eye.

It is because of this expertise that oculoplastic surgeons are therefore referred complex cases e.g. failed/unsuccessful previous surgery, revisional blepharoplasties by other surgeons both in the NHS and in private practice.

Mr Cheung is a member of the British Oculoplastic Surgeons Society
(www.bopss.co.uk), a fellow of the Royal College of Ophthalmologists (www.rcophth.ac.uk), a fellow of the Royal College of Surgeons of Edinburgh (www.rcsed.ac.uk) and a member of the American Academy of Ophthalmologists (www.aao.org).

Mr Cheung strictly adheres to the
recommendations of the General Medical Council on cosmetic surgery

  • Complex simultaneous eyelid elevation and lower surgery

    Before complex simultaneous eyelid elevation and lower surgery: Her right eyelid is low from damaged tendon from contact lens wear. Her left upper eyelid is high from tendon scarring from thyroid eye disease

  • 1 week following surgery

    1 week following complex upper eyelid oculoplastic surgery: Consisting of blepharoplasty surgery to both upper eyelids to tidy up any excess skin, elevation of the right upper eyelid (ptosis correction surgery) with left upper lid lower surgery (levator recession)

  • 6 weeks following surgery

    6 weeks following surgery. The patient was over the moon. Her eyelids now show perfect symmetry, contour and height

  • Simultaneous ptosis and cicatricial ectropion correction

    Before complex simultaneous ptosis and cicatricial ectropion correction. Note this gentleman has a droopy upper eyelid (ptosis) and out turning (ectropion) on his same left side. His left upper eyelid is low due to age related stretching of the main tendon. His out turning lower eyelid was due to skin tightness which would therefore require either a flap of skin or skin graft to relieve the tightness. The tightness of the lower lid skin was due to age related descent of the cheek (cicatricial ectropion)

  • 5 days following surgery

    5 days following surgery: The upper eyelid tendon has been repaired and tightened therefore lifting up the upper eyelid (ptosis correction). A flap of excess skin has been moved from the upper eyelid into the lower eyelid thus relieving the lower lid tightness

  • 6 weeks following surgery

    6 weeks following surgery. All the swelling has resolved. The patient was very happy. Both the upper lid ptosis and the lower lid ectropion have been corrected

Functional oculoplastic surgery vs. cosmetic/aesthetic oculoplastic surgery
Most patients who undergo oculoplastic surgery under the NHS (or under private insurance schemes) undergo what is is known as functional or reconstructive oculoplastic surgery, for example for droopy eyelids, watery eyes, eyelid cancers. This is because these conditions are considered important and debilitating enough that the Department of Health considers that their treatment should be covered by the NHS and should therefore be free at the point of treatment.

As our society continues to live longer and longer due to a combination of better healthcare, nutrition and lifestyle; increasingly both men and women of all ages are seeing their appearance as an important factor in how they feel about themselves. Nowadays, it is common for people to feel younger and more active than their parents or grandparents did at the same age. For many people, the decision to have cosmetic surgery is a natural choice to improve their quality of life. Most surgery which is considered purely cosmetic is not covered by the NHS or by private insurance schemes and is self funded by the patient. However they see the costs as a worthwhile and lasting investment which continues to contribute to their happiness and psychological well being.

Most cosmetic oculoplastic surgery is termed rejuvenation surgery i.e to reverse/delay the changes due to ageing.

As with most cosmetic surgery, this surgery is not absolutely necessary to your health and should therefore be considered very carefully before embarking on it. Mr Cheung strictly adheres to and recommends the advice of the British Oculoplastic Surgery Society on cosmetic surgery and the General Medical Council
If you are considering cosmetic plastic surgery, you should examine your own reasons very carefully first. You should develop realistic expectations of what to expect and decide in your own mind what changes you wish your surgeon to perform. Before embarking on surgery, your surgeon should be sympathetic and understanding to your wishes but also advise you on what can be realistically, and more importantly safely, achieved.

Cosmetic surgery by itself is not a panacea for major life problems or interpersonal relationship issues. However if performed well, successful cosmetic plastic surgery, by improving your appearance and how you see yourself, can often boost both your self esteem and confidence.

For further information on how to choose your oculoplastic surgeon, visit www.bopss.co.uk.

In 2004, the different UK Royal colleges/societies, which represent the different specialities of surgeons who offer cosmetic surgery, jointly drafted recommendations to help their patients. To download their recommendations click here
The Department of Health website also has very useful pages for patients considering cosmetic surgery click here
Although It is not imperative to ask your GP to refer you to Mr Cheung, on the whole it is often beneficial since your GP will often be able to provide a lot of important medical information in the referral letter. Often after discussing with your GP first, will be quite comfortable about referring you to Mr Cheung or another Ophthalmic and Oculoplastic Surgeon who is registered on the Specialist List of the UK General Medical Council. The General Medical Council recommends that your GP should be kept informed of all medical treatment that you undergo, and Mr Cheung will abide by this guideline.
The goals of surgery should always be determined jointly between you and your surgeon. It is very important to make clear your requirements at the time of your consultation.

Bad plastic surgery is easily recognisable. Instead of enhancing the features it invariably detracts from them. Furthermore, poorly performed plastic surgery in the eyelid region can also prove a threat to the health of the eye and eyesight.

Well performed oculoplastic surgery should be safe for the eye and is often subtly enhancing. Patients commonly report following surgery that their work colleagues still do not know that they have had any surgery done but ask if they have been holiday as they look refreshed in some way.

Oculoplastic surgeons perform a similar range of eyelid procedures, including blepharoplasty and brow lift both in the NHS and in private practice and are recognised accordingly as specialists in surgery in the eyelid region of the face. It is for this reason that they are referred patients, who have had unsatisfactory surgery elsewhere, for revisional work.
Unlike many clinics elsewhere, once you attend for a consultation with Mr Cheung and agree to proceed with a specific treatment, rest assured that your treatment will be carried out by Mr Cheung only. He will however on occasion, have junior surgeons in-training assisting him during your treatment.
Firstly, common to all surgical procedures is an inherent risk of complications despite the highest standard of care and expertise. The majority of complications are either uncommon (less than 5% of cases) or rare (less than 1% of cases). However, it is important that before you agree to undergo any surgery or treatment that you ask about and fully understand the risks and side-effects of the procedure. As a surgeon of good standing, Mr Cheung will always go through the potential risks with you prior to any treatment.
Procedures vary greatly in complexity and the fees reflect this. Each patient is different and the treatment offered is bespoke for that patient. It is for this reason that many fees are not given in this website but you will be informed of all costs prior to your surgery. Mr Cheung's fees are in line with equivalent providers. Full payment will be due and payable before the day of your treatment or surgery.

Specialist Surgeon with a very friendly personality: Right from the initial consultation, David put my mind at ease, explaining all of my options clearly, along with pro's and con's for each. There was no pressure at any point to opt for any of the procedures, and all consultations were very relaxed. We had a few consultations leading up the surgery (Frontalis Suspension), each one giving me more confidence that I'd chosen the right Surgeon. The day of the surgery was again, very relaxed, which eased the slight nerves. David and his team were great throughout, providing commentary throughout so I knew exactly what was going on at all times. The surgery itself was slightly uncomfortable, but the only pain was from the initial anesthetic injections. Post surgery, I was given all of the medical ointments that I'd need, along with some advice for the following few days. The package also included a number of follow-up aftercare appointments, which again, David was great with, explaining each time the healing process, and what I could expect between the current and the next appointment. Overall I'm 100% happy that I made the right choice in choosing David, and wouldn't hesitate to recommend him to anyone needing surgery, or just a friendly consultation to explore their options.
AT: Review from Trustpilot.com

.... thank you so much for giving me my new eyes!! What a difference it has made to me, not just the fact that I can see more now than I could before, but I also have eyelids, a fact that my daughter keeps commenting on. She says that she has never seen me with eyelids before and she’s is almost 30!! People at work have commented that I look younger and fresher, without looking startled which is just what we wanted to achieve. I can’t believe that on the day of surgery I was so calm, I am usually quite an anxious person, particularly where hospitals and treatment is concerned, but your chats beforehand and on the morning of the surgery put me completely at my ease. I really can’t remember anything of what went on even though you told me that I was talking the whole way through. Please thank your theatre team for their care too....
Mrs AJ (Gibraltar). Surgery performed: bilateral upper eyelid blepharoplasty under local anaesthesia with twilight sedation as an outpatient procedure at the Edgbaston Hospital