Written by Dr. Julian De Silva

The Afro-Caribbean eyelid is anatomical different to the Caucasian eyelid. These differences are related to the underlying facial anatomy including the relatively full upper eyelids and full brow, fine upper eyelid show, lines in the lower eyelid with or without bags and variable dark rings and facial lines.

These characteristic changes usually occur as a consequence of facial ageing; however, genetics also have an important role. Some younger patients have genetic factors that result in lines, puffiness and dark circles from their twenties.

Dr De Silva favours conservative eyelid surgery that gives a natural looking result. For most patients the eyelid scars are hidden on the inside of the eyelid making them invisible to the eye. This is of key importance in ethnic eyelid surgery to avoid visible scars.

Dr De Silva has a large number of Afro-Caribbean patients, who travel substantial distances to be treated by an expert in ethnic eyelid surgery.

Woman's face, Afro-Caribbean Blepharoplasty - eyelid

What is Afro-Caribbean anatomy?

The eyelid is a key element of facial appearance as the eyes are the first point of communication between people in the form of eye contact. Anatomic variations typical of each ethnicity are also present in the facial skeleton, contributing to facial harmony. The Afro-Caribbean eye position is characteristically more forwardly positioned, medically termed proptosed) which is secondary to the underling shape of natural ethnic bone.

Other common changes are dark circles or swelling around the eyelids. The lower eyelid has multiple complexities in its anatomy with attachments of ligaments muscles that must be respected with surgery. A combination of eyelid surgery and volume enhancement with regenerative cells can enhance the appearance in this area.

Dr De Silva’s eyelid surgery techniques?

Ideally, a beautiful eyelid should have a gentle arc that sweeps from the nose towards the cheek often with a small 1-2mm incline. The upper eyelid has a crease that determines the amount of upper eyelid show, often in ethnic blepharoplasty there are differences in the degree of eyelid show and the surgery must be individualised with cosmetic and plastic surgery. The position of the brow is frequently low and must be taken into consideration in ethnic blepharoplasty and for some patients elevation with a conservative brow lift is required, care is required to ensure the brow looks natural and as over-lifting creates an unnatural or surprised look, Dr De Silva does not use techniques that create an unnatural appearance. In the lower eyelid regenerative medicine techniques can improve the appearance of the skin quality particularly improving dark shadows and rings below the eyes.

What is the recovery after eyelid surgery?

Dr De Silva uses the latest in technology including regenerative medicine to enhance recovery after surgery. Utilising your own growth factors, and advanced techniques used by professional athletes your recovery can be speeded up.

Afro-Caribbean photomodel - smiling female

Will I have dry eyes after eyelid surgery?

In the ethnic eyelid important consideration should be given to the septum and the orbicularis muscle. The orbicularis muscle provides a key function in blinking of the eye and excessive surgery on the orbicularis can result in symptoms of dryness. Dr De Silva favours conservative surgery to reduce preserve the functioning of the eyelids and by removing the correct amount of skin improve both the cosmetic appearance of the eyelid and the blinking eyelid function.

What does eyelid surgery involve?

The main objective of eyelid surgery is to enhance the appearance of your eyelids and other facial features so that the final result preserves the individual’s ethnicity while improving and rejuvenating their appearance. To achieve this result, the following elements must be altered in the eyelids: the natural skin crease, orbicularis muscle, fibrous septum, fat pads, position of the lower eyelid (termed lateral canthus & the retractors), rhytides and eyelid-cheek junction. In conjunction with eyelid surgery often additional specialist techniques are required to give the best natural looking result including, volume enhancement with fat transfer, regenerative medicine, ptosis correction (droopy eyelid), tear trough depression and dark circles. Dr Julian De Silva avoids changing the eyelid shape by the use of delicate lipo-sculpture of the fat prolapse in the lower eyelids making incisions on the inside of the eyelid and adding advanced support to the lower eyelid during the healing process.

What will my friends and family think?

Many patients are concerned they will look too different after surgery and family or friends will notice. The eyelid is a key element of facial appearance as the eyes are the first point of communication between people in the form of eye contact. Loose skin, puffiness, bags, lines and dark circles all give a more tired appearance. Good eyelid surgery is discrete with hidden scars, patient’s report to Dr De Silva every week that most of their friends and family could not tell they had undergone surgery until shown before and after photos.

Woman's face, Afro-Caribbean Blepharoplasty: Eyelid. What will my friends and family think?

What type of anaesthesia is used?

Sedative anaesthesia, also known as “twilight anaesthesia,” which is combination of local and sedative medications. At the centre we have developed our own advanced form of twilight anaesthesia, based on practices in the USA. This specialised sedation uses tiny amounts of four to five sedation medications that cumulatively give a relaxing and safe experience avoid the risks and side effects of general anaesthesia. A much shorter recovery period than general anaesthesia, with most patients able to leave 30 to 60 minutes following the procedure. These are the most advanced sedation techniques available, and the optimal option for patients considering Asian eyelid surgery.

For more information on sedation anaesthesia please click here.

Watch Video: Introduction to Dr. Julian De Silva for Out of Town Patients for Facial Cosmetic Surgery in London
Introduction to Dr. Julian De Silva for Out of Town Patients for Facial Cosmetic Surgery in London

Will I have visible scarring?

In ethnic blepharoplasty an important consideration is scarring. Dr De Silva uses innervational techniques to reduce scarring for patients. Key to normal healing of scars is surgical technique, choice of non-dissolving stitches and avoiding sun exposure in the healing period, as ultraviolet light, may cause darkening of the skin. Although dissolvable stitches are quicker for surgeons, in some patients these may increase scarring, for this reason Dr De Silva does not utilise these stitches. In patients who have marked propensity for scars, Dr De Silva uses additional non-scarring agents to improve healing after surgery.

Watch Video: My personal experience of hidden scar lower blepharoplasty with Dr. Julian De Silva
My personal experience of hidden scar lower blepharoplasty with Dr. Julian De Silva

100s of experiences of Dr De Silva’s patients



5.00 from 524 reviews

By EL, Lower Blepharoplasty with fat transfer, laser and milia removal on May 19, 2020

I had lower eye blepharoplasty, with fat transfer, PRP, laser resurfacing and milia removal. I had researched and wanted the surgery for about 2 years before deciding to have some consultations I had two consultations with a well known surgery group but did not feel confident. I then met with Dr. De Silva and knew as soon as the consultation was over that I felt confident enough to go ahead and am so glad that I did. My pre treatment appointments and advice were so thorough, and any questions that I had were answered so quickly by the clinics staff. The day of my surgery was seamless, and I felt in completely safe hands the entire time from the nurse Ellie, to the Dr performing sedation and Dr De Silva. The follow up appointments were really thorough and no question too small. I am really pleased with the results and am so glad I had the surgery with Dr De Silva. If you are considering surgery I would highly recommend visiting Dr De Silva. Thank you so much.
read more

By Upper & lower blepharoplasty Jan 1, 2020

I recently underwent an upper & lower Blepharoplasty with Dr DeSilva and the results are outstanding! From my very first consultation and after lots of research, I knew that I had made the right decision to go with Dr DeSilva. Naturally I was nervous but his amazing team were all very kind, extremely friendly and totally relaxed. The procedure was carried out under sedation and that too was fantastic. I can honestly say I felt no pain during and after the procedure and within 1 hour afterwards I was on my way home. I would 100% fully recommend Dr DeSilva to anybody considering a procedure such as mine. Thank you Dr DeSilva, you have instilled a new found confidence in me.
read more

Lower Blepharoplasty Dec 25, 2019

I had lower blepharoplasty surgery as I had a lot of wrinkles in my lower eyelids. I have big eyes so the wrinkles were very obvious and only being in my mid-thirty’s I felt it aged me. The surgery was only an hour long and Dr Julian and his team were all really nice and caring. I am extremely happy with the results and my eyes look so much better! The wrinkles are hardly there and I actually like how my eyes look in photos now! I definitely recommend Dr Julian and his team.
read more

Read More Reviews Here *Results May Vary

What will enhance the results of eyelid surgery?

The skin around the eyelids is less than half millimetre thick. For this reason, every detail matters. A common finding in ethnic blepharoplasty patients is the appearance of a dark ring beneath the lower eyelid at the junction between the eyelid and the cheek. For these patients, Dr De Silva uses an advance fat transfer technique to enhance the result, this involves taking a small volume of fat from around the belly button, concentrating the fat, and inserting this in micro-aliquots into the ring depression. Dr De Silva uses special micro-cannulas to insert the fat avoiding incisions in the skin and placing it precise locations between the eyelid and the cheek. The fat is placed into specific areas around the eyes that are specific to the individual, including the junction between the eyelid and cheek, cheek, eyebrows, glabellar, temples and lateral canthus. This specialised treatment considerable improves the longevity of the result and improves the overall quality of skin as the transfer included regenerative cells. Dr De Silva utilises the most advanced modern techniques to enhance the results from surgery.

Can ethnic blepharoplasty be combined with other procedures?

Dr De Silva frequently combines upper eyelid surgery with other facial procedures:

  • Blepharoplasty
  • Lower eyelid surgery for puffiness (eye bags)
  • Rhinoplasty (enhance bridge and narrow features of nose, more definition to nasal tip)
  • Chin augmentation and facial balance
  • Facelift (deep plane, natural facelift)
  • Regenerative medicine
  • Volume enhancement with fat transfer.
  • Droopy eyelid (Ptosis correction)
Middle Eastern female, photo model

Related Topics

Stay Connected on

Email Call Map Hours

Covid-19 Update

Through the new phase of restrictions in the United Kingdom, The Centre London will remain open for patients. We are proud to offer our services in a CQC registered clinical environment, with strict COVID hygiene and safety protocols. Our Team will contact you should your appointment need to be changed, otherwise, we look forward to seeing you at 23 Harley Street.