Eyelid Specialist

After deciding that you are interested in an eyelid procedure, choosing the right cosmetic surgeon is one of the most important steps. What follows are recommendations on which aspects may be most important in choosing the proper plastic surgeon to perform your blepharoplasty.

Find a Plastic Surgeon that Matches Your Aesthetics and Philosophy

Unlike other surgical specialties, cosmetic surgery represents at least in part an art. The plastic surgeon’s eye for facial aesthetics and harmonious balance of the structures is important in planning a procedure. If the plan is not right, the final outcome certainly will not, too. Therefore, you should listen to the surgeon’s analysis of your face and his treatment plan. If what he sees is what you see in the mirror, then that may be a good match. If there are great discrepancies, then his aesthetic sense may differ from yours. If he knows that you want to talk about your eyelids and he does not talk about your face in general, he may be missing key aspects to a pleasing outcome. Watch out if the surgeon sounds more like a sales representative than your advocate!

The Trend to Sub-Specialization

Over the years, the field of surgery has enjoyed a tremendous growth in procedures, techniques and instruments. The single surgeon who is good at everything is almost obsolete in today’s modern and demanding health environment. The same is true for plastic surgery. Although there may be some plastic surgeons remaining who are good at every procedure of the face and body, this is a rarity today. Because of this strong trend to sub-specialization, many experts consider plastic surgery today rather a technique than a specialty. This is reflected in the many specialties performing plastic surgery procedures within their areas of expertise. General plastic surgeons, for instance, often go on to further focus on specialties such as hand surgery, free flap reconstructive surgery, breast surgery etc. Within head & neck surgery, facial plastic surgery has emerged as a distinct sub-specialty. And oculoplastic surgeons usually emerge from eye surgeons and cares for disorders of the eye, eyelids, lacrimal system, and orbit (a.k.a. eye socket). Although rarely, surgeons with other backgrounds (i.e. dermatologists, maxillofacial surgeons, general ophthalmologists, head and neck surgeons or gynecologists) may perform eyelid surgery, too. In general though, facial plastic surgeons, general plastic surgeons and oculoplastic surgeons perform by far most cosmetic eyelid procedures today.

Choose an Experienced Eyelid Surgeon

Given the delicate and precious nature of your face and eyelids in particular, identifying the right doctor for you is important. For instance, a plastic surgeon that performs mainly cosmetic and reconstructive breast surgery may not be as comfortable with blepharoplasties. And an eye surgeon who performs cataract, LASIK or glaucoma work may also not be experienced with cosmetic eyelid surgery. On the other hand, a plastic surgeon, which performs many cosmetic eyelid lifts, will likely be proficient with blepharoplasty. Therefore, we feel that experience with a particular operation is a paramount quality to look for. Why? As every plastic surgeon can attest, cosmetic surgery is an art and science of constant learning. In the hands of the detail-oriented and perfectionist plastic surgeon, a blepharoplasty patient today will benefit from experience gained from the last 100 procedures. Fine tuning of the technique and critical assessment of prior results will make the cosmetic surgeon better. Most busy eyelid specialists perform in excess of 100 blepharoplasties a year.

Avoiding Complications by Choosing a Blepharoplasty Specialist?

The experienced eyelid specialist understands the delicate nature of the lids with its complex structural anatomy and importance in protection and fostering of the eye. Performing any procedure frequently will likely lead to a decrease in complication incidence. But whenever invasive procedures are performed, the risk for problems is a real one and never nil. A surgeon who never encountered a problem in his patients either has not performed enough of the procedure in question or lacks careful analysis and self-critique. For instance, when judging the extent of fat removal necessary in the lower lids, the surgeon walks a fine line of just right: there is too much on one side and too little on the other. If a surgeon claims that he or she never removed too much or left something extra behind, the credibility of this doctor should be questioned. (Hopefully, the surgeon tends to err on the side of conservatism, if in doubt.) The advantage of experience lies in managing problems when they arise. First, the problem needs to be recognized in order to address it appropriately. Second, deciding on the best mode of management is a skill that is best taught by experience.

Choose a Cutting Edge Cosmetic Surgeon

If you have friends who underwent blepharoplasty, facelift or other facial rejuvenation procedures, ask them if they had a good experience. When you meet with a surgeon, ask him how experienced he is with blepharoplasty. Does he perform advanced eyelid procedures? Many of these modern techniques have been developed over the last 7 to 10 years and it may be to your advantage to be able to benefit from the recent progress. When you talk to a plastic surgeon, you will get a feel for his desire to provide state-of-the-art services or whether he performs eyelid procedures today the way he did 20 years ago.

Should I Meet with Multiple Surgeons before my Eyelid Lift?

The short answer is: “Yes, if in doubt”. There are many advantages to meet with more than just one surgeon. First, you will see if these surgeons agree on the appropriate procedure for you. If you talk to 3 surgeons and you get 3 different opinions, you should take this into consideration. Considering various opinions will automatically make you more confident in your final decision. During your consult, you will get an appreciation for the plastic surgeon’s particular style and techniques which reflect his background and experience. Rarely, if presented with a face, all cosmetic surgeons asked will agree on one single plan.

Board Certification

Board certification informs you if a doctor’s specialty training provided him with appropriate training during residency. Although this may be interesting to evaluate novice surgeons, this holds little value in understanding the surgeons practice and skill in a particular procedure years after training (“If you don’t use it, you lose it”). The question of board certification is difficult to represent accurately and fairly by most doctors. And it is certainly difficult to interpret by patients. Most practicing physicians today are board-certified. But this does not mean that they are specialists in a particular area. For instance, all orthopedists are board-certified to perform hand surgery but most do not practice hand surgery because of the specialized and demanding character. Similar things hold true for eyelid lifts. Most surgeons who are board-certified to perform eyelid lifts (i.e., plastic surgeons, head & neck surgeons, ophthalmologists) do not perform this procedure. Therefore, the value of relying on board-certification only is rather obvious. Most people do believe that a surgeon should be board-certified for the surgeries he performs. But one should go further and ask about the surgeon’s experience and skill in blepharoplasty. Unfortunately, over the last decade, the question of board certification has developed into a turf conflict where patients are left confused and misinformed. Usually, whenever one group of doctors claims exclusive rights to a procedure, the red flags of protectionism should go up. The notion that a surgeon’s specialty background automatically qualifies or disqualifies him from performing certain plastic procedures, unfairly limits the patient’s choice of qualified experts.

For more information, please contact Dr. Fechner.

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