The training path

In Canada, an oculoplastic surgeon first completes medical school and a residency in ophthalmology, the medical and surgical specialty of the eye. Certification by the Royal College of Physicians and Surgeons of Canada is indicated by the letters FRCSC. Oculoplastic surgeons then complete a fellowship of one or more years focused on the eyelids, tear drainage system, orbit and surrounding face.

That means years of eye-specific training before eyelid surgery specialization begins. More about our team is on the About BLEC page.

What oculoplastic surgeons treat

The specialty covers a wide range of conditions around the eye:

  • excess eyelid skin and under-eye bags (upper and lower blepharoplasty);
  • droopy eyelids (ptosis) and eyelids that turn in or out;
  • eyelid lumps, cysts and skin cancers, including reconstruction after removal;
  • watering eyes from blocked tear drainage; and
  • conditions of the orbit, such as thyroid eye disease.

Why the eye changes the surgery

The eyelids protect the cornea, spread the tear film with every blink and keep the eye moist overnight. Eyelid surgery that ignores these functions risks dry eye, exposure of the cornea or incomplete closure. An oculoplastic surgeon plans around the eye, because the eye is their first specialty, and assesses tear film, blink, lid support and eye health as part of every eyelid plan.

Functional and cosmetic together

Drooping eyelids, lid malposition and watering eyes are functional problems with cosmetic consequences. Blepharoplasty is often considered cosmetic but has functional dimensions, such as restoring the upper field of vision. The same specialty handles both because the anatomy is the same, and many patients have a mixture of functional and aesthetic concerns.

Reconstruction after eyelid skin cancer

Eyelid skin cancers are usually removed with a margin of healthy tissue to make sure they are fully cleared. Rebuilding the eyelid afterwards requires restoring its layers, its margin and its ability to close and blink, so the eye stays protected. Eyelid reconstruction is a core part of oculoplastic training, and the same principles of protecting function guide cosmetic eyelid surgery.

Thyroid eye disease and the orbit

Thyroid eye disease can cause eyelid retraction, bulging eyes and puffy lids. Its management often involves several specialists over time, and eyelid surgery is usually considered only once the condition has stabilized. Oculoplastic surgeons are trained to plan eyelid and orbital surgery in the right sequence for these patients.

What this means for your consultation

Expect questions about your eye health, dryness, contact lens use and vision, not just your appearance goals. Expect the surgeon to explain how the plan protects eyelid closure and the eye surface. These questions are a feature of the specialty, not a detour. Our guides to upper blepharoplasty candidacy and lower blepharoplasty candidacy describe what the assessment covers.

Choosing any surgeon

Whatever specialty you consider, reasonable questions include the surgeon's training and certification, their experience with your specific procedure, where the surgery will be performed, how complications are handled and what the plan would be if your anatomy turns out to differ from expectations. A good surgeon welcomes these questions and will also tell you when surgery is not the right step.

Questions to ask at your consultation

  • What is your training and certification?
  • How often do you perform the procedure I am considering?
  • How will the plan protect my eye surface and eyelid closure?
  • How are complications handled, and who do I contact after hours?
  • What would you recommend if surgery is not the right step for me?