Cosmetic and Reconstructive Surgery

As the most senior and longest-serving oculoplastic surgeon at Moorfields Eye Hospital, Mr Uddin has considerable experience in cosmetic and reconstructive eye surgery for common as well as complex, revisional and unusual cases. With a national and international referral base, he is known for delivering exceptional and personalised care, resulting in the most effective surgical outcomes. He offers a comprehensive range of treatments in an open and safe clinical environment.

Mr Uddin believes that both aesthetics and function are important. All treatments and procedures are tailored to the individual, taking into account their personal needs, wishes and unique characteristics. Mr Uddin is passionate about giving patients autonomy over their care and always discusses the realistic outcomes and side effects with any given treatment.

The eyes and eyelids are the central focus of the face

The eyes and eyelids are the central focus of the face, with the brow & upper face superiorly and midface & cheek inferiorly, all underpinned by the orbital soft tissues and facial skeleton. When considering changes and conditions affecting the eyes and eyelids, the whole face and deeper structures need to be considered together.

The aesthetic and cosmetic aspects of eyelid changes are often apparent and most important to the individual. These need to be addressed with an understanding of visual function and the delicate, complex and inter-connected anatomy of the eyelids, face and orbit. Mr Uddin is passionate about providing the best, most suitable treatment promptly, so that his patients can have an improved quality of life and feel better about themselves.

Multidisciplinary care

He is a great believer in collaboration and multidisciplinary care when required. This is especially the case with facial reconstructive and cosmetic surgery where sometimes the issues and outcome involve more than just the eyelids and orbit. MDT care is especially important in the treatment of tumours and trauma.

He has developed close long-standing working relationships with excellent teams of maxillofacial surgeons, specialists in ear nose and throat surgery, neurosurgeons and plastic surgeons based at Moorfields Eye Hospital and other highly recognised specialist centres such as St George’s Hospital Medical School, Guys & St Thomas’s Hospital and UCL Hospitals.

Orbito-facial trauma and tumours

Working with colleagues, he has been pivotal in developing partnerships that deliver excellent results for patients with complex eyelid problems, patients needing orbital reconstructive surgery and patients who have conditions that also involve the facial bones, sinuses, face and intracranial processes. Orbital trauma and tumours are a large part of Mr Uddin’s work. He enjoys driving and delivering the best care for all his patients.

The aesthetic and cosmetic aspects of eyelid changes are often apparent and most important to the individual. These need to be addressed with an understanding of visual function and the delicate, complex and inter-connected anatomy of the eyelids, face and orbit. Mr Uddin is passionate about providing the best, most suitable treatment promptly, so that his patients can have an improved quality of life and feel better about themselves.

What is oculoplastic surgery?

Oculoplastic surgery is an overarching term for surgical procedures involving the orbit (eye socket), eyelids, tear ducts and the face. It can be undertaken for improving the form and function of the eye as well as for cosmetic reasons. Oculoplastic surgeons are ophthalmologists who have undertaken highly specialised training in oculoplastic surgery involving the eyelids, orbits and face.

Why choose an oculoplastic surgeon for eyelid conditions?

Oculoplastic surgeons are best placed to assess, diagnose and plan for the needs of eyelid and periocular conditions, placing emphasis on eye function, as well as aesthetics. Oculoplastic surgeons train as ophthalmologists (general care of the eye) and then undertake further training in eyelid, facial and orbital aspects of eyelid problems and ageing. Oculoplastic surgeons understand the special periocular anatomical and functional relationships of structures in this area of the face.

What cosmetic procedures does Mr Uddin offer?

There is a number of reasons why people choose to undergo cosmetic eye surgery, including dissatisfaction with their appearance or a desire to alter the effects of ageing. Mr Uddin offers a wide range of both surgical and non-surgical procedures. These include:

Upper and lower eyelid blepharoplasty
Brow surgery
Mid-face lift
Fat transfer techniques
Botulinum toxin (Botox) injections/ fillers
Facelift/Eyebrow and forehead lifts

What is dermatochalasis?

What other ageing changes may occur with dermatochalasis?

What is Blepharoplasty Surgery?

A blepharoplasty is an operation to rejuvenate the eyelids and in some cases to improve vision where excess skin is obscuring it.
It may involve removal of excess eyelid skin.
Depending on an individual the muscle or fat underlying the skin may also be removed or repositioned.
In addition the lower lid may be tightened surgically.
The procedure can be carried out in the upper or lower eyelid.

Upper eyelid blepharoplasty

At the beginning of the operation the amount of skin to be removed will be carefully assessed. Marks will be drawn on the eyelid with a sterile marking pen to assist the surgeon during the procedure.
The incision is based in the skin crease of the upper lid, which helps to minimise any sign that you have had upper lid surgery.
After this, local anaesthetic will be injected under the skin in the upper eyelid.
The skin is removed with surgical instruments. Depending on your particular problem, the muscle beneath the skin may be preserved or partially removed.
If there is fat prolapse in the upper lid this may be treated with partial fat removal or repositioning.
Sutures are placed to reform the natural skin crease in the eyelid.
The skin edges are sutured together with either a continuous suture that is removed one week later or absorbable sutures that will naturally fall out after 2-3 weeks.
It may be performed alone or in conjunction with other procedures such as: lower lid blepharoplasty surgery; ptosis surgery; eyebrow surgery.
This operation may be carried out under general anaesthesia, local anaesthesia plus intravenous sedation or simply local anaesthesia on its own.
UDDIN BOPSS upper and lower blepharoplasty leaflet
Blepharoplasty Moorfields information sheet

Lower eyelid blepharoplasty:

There are 4 elements to lower lid blepharoplasty: skin, muscle, fat and eyelid laxity. The procedure you have will be tailored to suit your problem.
Fat prolapse in the lower eyelid gives the appearance of ‘eye bags’.
This fat can be excised or repositioned over the orbital rim to create a smoother transition from the eyelid above into the cheek below.
Surgery on the prolapsed fat may be done without a skin incision from the inside of the eyelid – transconjunctival or via a skin incision just beneath the eyelashes – transcutaneous.
The lower eyelid usually needs to be tightened at the time of surgery. Even a small amount of lid laxity can lead to postoperative lower lid retraction or ectropion if not addressed at the time of surgery.
This tightening is called ‘lateral canthal suspension’ or ‘canthopexy’ and involves a suture from the lid to the bony rim of the orbit.
The orbicularis muscle, which lies directly beneath the skin is often tightened by placing sutures from it to the bony rim of the orbit – ‘orbicularis suspension’.
Lower eyelid skin is excised in much smaller amounts than in the upper lid. This is to avoid the unwanted side effect following surgery
UDDIN BOPSS upper and lower blepharoplasty leaflet
Blepharoplasty Moorfields information sheet

What are the benefits of surgery?

Both eyelid dermatochalasis and eyebrow ptosis may reduce the visual field due to the hooding of skin over the eyelid.
In an attempt to raise the eyebrow and eyelid people often use the forehead muscle. Fatigue of the frontalis forehead muscle may cause discomfort, particularly at the end of the day.
Surgery can therefore improve visual function and relieve some headaches.
It also will improve the appearance of the eyes with a fresher more awake look.

What are the alternatives to surgery?

There are no alternatives to surgery in correcting upper eyelid dermatochalasis Some patients weigh up the risks and benefits of surgery and decide to put up with the problem, feeling that the risks of surgery are too great for them – it is an individual decision.
Having dermatochalasis does not damage the eye, so it is a reasonable option to decline surgery if you wish.
In some cases non-surgical cosmetic treatments such as botulinum toxin injections (Botox) or subdermal fillers (Restylane) can be used to improve the appearance around the eyes.

Volume and fat transfer

Facelift

What reconstructive procedures does Mr Uddin offer?

The aim of reconstructive surgery is to restore form and function to damaged parts of the eye and surrounding features. Patients may have suffered from injury, infection or tumours resulting in a disruption of appearance or normal function. Mr Uddin is able to provide a comprehensive range of procedures including:
Reconstruction of the orbit, eyelids and face following:

Tumour reconstruction
Trauma reconstruction
Eyelid Malposition
Ptosis repair
Entropion repair
Ectropion repair
Enophthalmos/hypoglobus
Orbital dystopia
Burns associated deformity
Thyroid eye disease - functional and aesthetic rehabilitation surgery
Orbital decompression
Eyelid surgery
Eye removal and Socket surgery and artificial eyes

Mr Uddin is an active member of the European Society of Ophthalmic Plastic & Reconstructive Surgery (ESOPRS) and was a founding member of the British Oculoplastic Surgical Society (BOPSS). He continues to keep updated with the latest techniques and advances in oculoplastic surgery, so he is able to offer his patients the latest and most effective treatment options.