Upper eyelid blepharoplasty and ptosis repair
This patient underwent surgery to address excess upper eyelid skin and droopy upper eyelids. She had previously had her eyebrows tattooed and was keen not to change the position or contour of the brows.
A bilateral upper eyelid blepharoplasty and bilateral upper eyelid ptosis repair was performed resulting in an improvement in the upper eyelid position and reduction in excess upper eyelid skin. The result is natural, with preservation of the eyelid contour and restoration of the eyelid tarsal platform show.
Right upper eyelid ptosis repair
This patient was keen to address the asymmetry between her upper eyelids and underwent a right upper eyelid ptosis repair.
Subtle changes to the upper eyelid position can be challenging and Miles always strives for symmetry and a natural eyelid contour in ptosis surgery.
Bilateral direct brow lift and upper eyelid blepharoplasty
This patient’s heavy upper eyelids and brows were impacting on his visual field. An upper eyelid blepharoplasty combined with a direct brow lift was performed, resulting in a refreshed appearance, improved lid position and improved visual field.
A direct brow lift is one of the most powerful and reliable methods of lifting the brow. The scar is hidden in the brow line and fades over time, usually becoming almost undetectable.
Left upper eyelid epidermoid cyst removal
We treat a wide range of eyelid lumps and bumps, including chalazia, benign lid lesions, and periocular skin cancers. Most lid lesions are benign, as in this case of a left upper eyelid epidermoid cyst.
There are a variety of reasons why the surgical removal of an eyelid lesion may be necessary. These lesions can cause discomfort, be cosmetically unappealing, or, in some cases, be cancerous. Every lid lesion we remove is sent for histopathological analysis to confirm the diagnosis.
Benign lid lesions can be removed in-office, usually leaving an undetectable scar.
Customised male upper eyelid blepharoplasty
Blepharoplasty surgery offers benefits for all genders but requires a tailored approach for optimal results.
This gentleman was concerned about his heavy upper eyelids and underwent a customised upper eyelid blepharoplasty. His eyes appear more refreshed following surgery, whilst maintaining a very natural look.
Bilateral lower eyelid ectropion repair
Ectropion is a condition where the eyelid turns outward, exposing its inner surface. This can lead to irritation, excessive tearing, and discharge due to inadequate eye protection.
Aging is the most common cause of ectropion, as the muscles responsible for maintaining eyelid position weaken over time.
This gentleman underwent a bilateral lower eyelid ectropion repair to restore the eyelid position and function. In this case, floppy eyelid syndrome also contributed to the ectropion.
Left upper eyelid ptosis repair
Ectropion is a condition where the eyelid turns outward, exposing its inner surface. This can lead to irritation, excessive tearing, and discharge due to inadequate eye protection.
Aging is the most common cause of ectropion, as the muscles responsible for maintaining eyelid position weaken over time.
This gentleman underwent a bilateral lower eyelid ectropion repair to restore the eyelid position and function. In this case, floppy eyelid syndrome also contributed to the ectropion.
Bilateral upper eyelid blepharoplasty
This patient was concerned about his heavy upper eyelids and lateral hooding. To address these issues a bilateral upper eyelid blepharoplasty was performed, with a tailored approach to treat his lateral hooding.
The procedure rejuvenated the upper eyelids, improving both his visual function and appearance. The incisions were carefully designed to ensure no visible scarring and a natural result.
Orbital fat prolapse surgery
Fat from around the eye may push forward, often due to age related changes. Whilst typically harmless it can affect appearance and cause discomfort.
This patient underwent surgery to address his right orbital fat prolapse, resulting in a satisfactory cosmetic outcome.
Left eyelid trauma repair
The repair of eyelid trauma requires a precise understanding of anatomy and reconstruction principles in order to restore both function and appearance. Whilst the cosmetic outcome is of utmost importance, protecting eye health and vision is the primary focus of reconstruction.
In this challenging case, despite significant trauma to the lower eyelid and tissue loss, Miles was able to successfully restore the anatomy and function of the lid with a good cosmetic outcome.
Blepharoplasty for blepharochalasis
Blepharoplasty can be an effective solution for managing loose, sagging skin caused by blepharochalasis.
Blepharoplasty surgery removes excess skin, restores the natural eyelid contour, and can improve vision if sagging skin is obstruction the sight. In addition to functional improvements, blepharoplasty can enhance the appearance of the eyes.
Blepharochalasis is a rare condition and is characterised by intermittent, recurrent episodes of eyelid swelling and thinning. This differs from dermatochalasis, which refers to age related sagging of the eyelid skin without an inflammatory component.
Epiblepharon surgery
Epiblepharon is a condition in which a fold of skin and muscle near the eyelid margin causes the eyelashes to turn inwards and, in some cases, touch the cornea or conjunctiva. It is most common in children, particularly of East Asian descent, and usually affects the lower eyelids.
If lashes touch the conjunctiva or cornea this can cause ongoing irritation. Treatment options include conservative management with lubricant eye drops for comfort and protection, or surgical intervention, which is typically recommended if there is chronic irritation or corneal damage.
Surgery has a high success rate. Miles uses a technique that minimises scarring (which is subtle even in this close-up photograph). There is a short downtime of 1-2 weeks.
Right lower eyelid entropion repair
Entropion is the inward turning of the eyelid margin with malposition of the tarsal plate. The most common cause is age related weakening of muscles and tendons that support the eyelid. This is different from epiblepharon (above) where the pretarsal muscle and overlying skin ride above the eyelid margin, creating a horizontal fold of tissue that causes the eyelashes to turn inward, but the tarsal position is normal.
Entropion is common and usually affects the lower eyelids, but it can also affect the upper lids. If lashes rub on the ocular surface it can cause irritation and damage to the surface of the eye. Treatment options include conservative management with lubricant drops for comfort and protection, or surgical intervention, which is recommended if there is ocular surface irritation.
Surgical repair of entropion corrects the lid malposition and has a high success rate. There is a short downtime of 1-2 weeks.
Right lower eyelid reconstruction following Mohs surgery for Basal Cell Carcinoma
Basal cell carcinoma (BCC) typically presents as a slow-growing, pearly nodule with rolled edges and central ulceration (scroll right for the classic appearance of a nodular BCC).
BCC is the most common periocular malignancy, usually requiring surgical excision to remove the lesion and prevent progression. Mohs micrographic surgery is the gold standard for removing a BCC, ensuring complete excision while preserving as much healthy tissue as possible.
The goal of reconstruction is to restore eyelid function, protect vision, and achieve a good aesthetic outcome.
Early detection, Mohs surgery, and expert reconstruction lead to the best outcomes.
Right pterygium surgery
This pleasant lady underwent surgery to remove her right pterygium. A conjunctival autograft (the patients own tissue from the same eye) is used to promote healing and prevent recurrence. Post-operatively the cornea is clear and the patient is no longer symptomatic.
Miles regularly performs pterygium surgery in his practice.
Left micro ptosis repair
This delightful patient was concerned about her subtle droopy left upper. A left upper eyelid ptosis repair was performed to balance the upper eyelid heights, improving symmetry and refreshing her appearance.
Micro ptosis repairs can be challenging and should be performed by an experienced oculoplastic surgeon who regularly performs ptosis surgery.
Lower eyelid tarsal ectropion repair
This patient underwent surgery to repair a severe right lower eyelid ectropion. This is a common condition of ageing and often causes discomfort and secondary dry eye.
Miles takes care to restore the anatomy of the lower eyelid and avoid blunting of the lateral canthal angle.
Lower eyelid entropion repair
This patient was troubled by his right lower eyelid rolling inwards (entropion) which resulted in constant irritation due to the lashes scratching the surface of the eye.
The eyelid malposition was repaired and care was taken to restore the anatomy of the lower eyelid, leaving a natural result and avoiding any blunting of the lateral canthal angle.
Bilateral upper eyelid ptosis repair and blepharoplasty
This gentleman was troubled by droopy upper eyelids and excess upper lid skin. He underwent surgery to address this. The objective was a natural result with restoration of the upper eyelid position and eyelid contour.
Left upper eyelid ptosis repair
This patient was troubled by a droopy left upper eyelid and underwent and anterior approach left upper eyelid ptosis repair, resulting in an improved position of the eyelid and a balanced appearance.
Removal of giant lacrimal sac diverticulum
This gentleman presented with a large benign lacrimal sac swelling. This was surgically removed to restore the anatomy of the medial canthus.
Right orbital fat prolapse repair
This gentleman was bothered by right orbital fat prolapse, most noticable on left gaze. The fat was debulked to restore the appearance of the eye.