Five Things to Remember Before Cosmetic Eyelid Surgery

Your face is the focal point of your presence. As you express yourself, attention centers on your face, and especially upon your eyes. The eyes reveal a great deal about each person, and they convey lasting impressions. What do your eyes say about you?

The eyelids change with time, and become more puffy and saggy. For the most part, you might accept these changes as natural, and choose not to do anything about it. But inevitably, you are reminded-when you look in the mirror, or perhaps by another person's comment-that you are not content with the appearance of your eyes.

The time comes to move forward, to strengthen yourself and your appearance, and to take a true step toward looking better. Many people are making the same decision, and cosmetic eyelid surgery ranks as one of the most popular cosmetic procedures in the United States.

As you consider having cosmetic eyelid surgery, you must navigate through a large number of advertisements, personal referrals, doctors, and inner doubts. The following five points are quite useful in ensuring that you are approaching eyelid rejuvenation with a careful, informed, and organized manner.

1. The eyes are the most important part of the face.

Your eyes are very delicate and sensitive, and they perform one of the most important functions of your entire body. Your vision is more precious than anything else on your face!

The eyelids are not just flaps of skin. In fact, they are completely different from any other skin in the body. Unlike most of your skin, the eyelids perform several vital functions. Protecting the eyes from light, lubricating the surface, draining tears, and filtering dust away from the eyes are just a few of the major functions of the eyelids.

So eyelid surgery affects both the appearance and the function of the eyelids. It is very, very common for eyelid surgery to result in temporarily blurry vision and/or irritated eyes. It is critical that you have a supportive and knowledgeable surgeon and staff to guide you through the immediate postoperative period.

As you may know, there are many surgeons who perform cosmetic surgery of various types, from breast augmentation to liposuction to face lifts. You may want to consider consulting with an eyelid specialist, a cosmetic surgeon who focuses exclusively on the eyes.

Since 1969, the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS) has been dedicated to the advancement of eyelid surgery. Membership requires being Board-Certified in Ophthalmology, completion of a Fellowship in Ophthalmic Plastic & Reconstructive Surgery, completion of an original thesis, and written and oral examinations. Currently, only 440 surgeons around the world have been granted membership in ASOPRS.

Many organizations have similar initials, and it can be quite confusing to know which qualifications are most important. But the basic point remains: for cosmetic eyelid surgery, you should strongly consider an eyelid specialist, certified by ASOPRS.

2. Cosmetic eyelid surgery is a constantly changing field.

Incredible advances are being made every year in the science of eyelid rejuvenation. New technology, new medications, and new surgical techniques are introduced more rapidly now than ever before.

The aesthetic results of cosmetic eyelid surgery are far better now in general than at any time previously. We have much higher expectations.

It is quite important to select a surgeon who is well-versed with the latest knowledge and the newest procedures. The use of older approaches and outdated technology has fallen out of favor.

Certain surgeons are also teachers, and hold academic rank at medical schools. In order to be an Assistant Clinical Professor, for example, one is required to volunteer time every month for teaching and training young surgeons. It requires being comfortable with the most modern techniques. It is certainly worthwhile to select a cosmetic surgeon who also holds a teaching position.

Does your specialist keep up to date with the newest advances? Does he/she consistently attend lectures and conferences? An example is the Annual Scientific Symposium of the ASOPRS (described above). It is a 2-day event, with lecturers from all over the world, reporting the results of eyelid research. Does your cosmetic specialist attend this meeting? If not, how would he/she be familiar with technological and surgical innovations related to eyelid surgery?

3. Everyone has a different sense of beauty.

We often assume that what is attractive to us, will also be attractive to others. In reality, this is rarely the case. Each of us has a very, very specific sense of aesthetics. In other words, we have our own mental image of a beautiful face, and it requires a unique combination of factors that most other people simply don't see.

This explains why it is typically very difficult for one person to tell another person why something is beautiful. It explains why art affects each person differently.

It also forms the basis for a common miscommunication between patient and cosmetic specialist. Patients honestly believe that the surgeon will automatically know precisely what outcome the patient has in mind. As previously stated, this is not always the case.

The best cosmetic surgical outcomes occur when expectations, desires, and probabilities are clearly communicated between the patient and the doctor. Therefore, one of the most important skills of a cosmetic surgeon is the ability to listen carefully.

There is a difference between "hearing" and "listening." Any doctor will hear what you are saying, but the ideal cosmetic eyelid surgeon will listen to your concerns and provide a realistic plan to address each issue.

4. Understand what improvement you seek, and why you are seeking it.

We've discussed the qualities that make a good cosmetic eyelid surgeon…now let's talk about what makes a good patient.

The first step in rejuvenating your face and eyelids is to know precisely what you want. What part(s) of the face are bothering you? What part(s) are you happy with? If you improve one area, will it make another area appear worse? Do you need a complete facelift, or simply eyelid rejuvenation? Does your face need more than you (and your budget) are willing to admit?

A very common reason for patient-doctor miscommunication: the patient's goals and desires are never clearly decided at any point, leading to a dissatisfied patient and a frustrated surgeon. Take time to think carefully about what changes would make you happy, and what changes would leave you disappointed.

The second step in rejuvenating your face and eyelids is to discover your inner reasons for desiring the procedure. It is truly a "discovery," because many people have motivations that are deeper and more profound than just "to look nicer." Are you seeking a new romantic partner? Hoping to get a promotion? Revenge on an ex-spouse? All of these are bad reasons for having cosmetic surgery.

As an example, we had a very nice 64 yr.-old gentleman who requested cosmetic eyelid surgery. Upon every visit before and after surgery, he would complain bitterly about his ex-wife and their bitter divorce. Although his surgical result was excellent, he never felt fulfilled, because the surgery did not improve his personal life.

When thinking about yourself and your reasons for having cosmetic surgery, no one else should come to mind. Make sure that you are fundamentally happy with who you are and where you are in life before considering any cosmetic surgery. Avoid tying a surgical outcome to your personal happiness.

5. Cosmetic eyelid rejuvenation is a process, not a product.

Facial improvement is not a box that one can buy from a shelf, and it is not available from a drive-through establishment. There is no "overnight" service, and it does not take place "while-u-wait."

In our time-pressured, fast-food society, we are very impatient and we want immediate results. We want a perfect result, and we want it in 5 minutes. We apply this mentality to everything, including medical and surgical treatment.

Cosmetic eyelid surgery does not work that way. There are 2 basic rules about the process: first, the healing time from surgery differs from individual to individual, and cannot always be accurately predicted; second, the more change you want, the more healing time ("downtime") is required.

If you desire a rapid recovery with little downtime, then you will need a non-incisional procedure which will produce very subtle, very gradual results, at a slow pace. Examples include intense pulsed light therapies, chemical peels, and microdermabrasion. Such treatments usually need to be repeated several times in order to see any effect.

On the other hand, if you desire a more dramatic change, then surgery is most often required. You must allow plenty of time for recovery, and should not schedule any social events or a return to work until nearly finished with healing. Complete recovery can take months in some cases. Also, you should be prepared for the possibility of a secondary "touch-up" procedure to help achieve the best possible cosmetic result.

Eyelid rejuvenation is a process. It has many steps, it takes quite a bit of time, and it is dynamic, ever-changing.

George H. Garcia, MD, is a cosmetic eyelid surgeon practicing in Orange, California. He is an Assistant Clinical Professor at the UCLA School of Medicine and Jules Stein Eye Institute, and is an active member of the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS). For further information, please call 714-633-3404.

Copyright, 2003, George H. Garcia, MD