If orbital fat is seen bulging, a structurally fibrous layer known as the orbital septum is opened. The fat is generally removed or shaped, although in some cases the fat is repositioned without excision.
Dr De Silva favours conservative removal and repositioning of fat as over-removal of fat can resulted in a “hollowed-out” appearance to the eyelid that is unappealing. Although it is always possible to remove more soft tissue including fat, it is much more challenging to correct once too much fat has been removed. Thirty percent of the patient’s Dr De Silva treats have had previous eyelid surgery, the eyelids are an intricate part of the face where millimetres make a considerable difference.
Dr De Silva uses specialised state of the art technology including a US-manufactured CO2 laser or monopolar electrocautery to establish meticulous control of bleeding, key to preventing both bruising and preserving good vision after surgery.