<p>I’ve thought of that, too, but it’s only going to get worse. I guess my thoughts are to do it now and enjoy it for years to come…the difference will just make me look refreshed rather than a drastic change. My mother told me to wait a couple of years so I would only have to do it once. To be honest, the whole recovery thing and something could go wrong scares me…but I’m sure everyone feels like that. </p>
<p>Hells Bells…I just called and made another appt. with a 2nd oculopastic surgeon. He had a cancellation for tomorrow or I’d have to wait until the 3rd week of November…I’m going tomorrow. $125 consult fee, but it goes towards surgery if you elect to go forward. They also don’t have an imaging program…but my pics from the 1st one are on my phone! Maybe there is a reason I went to that guy first 
Will let everyone know how it goes and what he says.</p>
<p>@conmama,
I read your post. Here are my thoughts:</p>
<ol>
<li><p>My philosophy is that after surgery, you still want the patient to “look like themself” without changing their looks so drastically that they don’t “look like themself” anymore. I strive to make them look like how they looked when they were younger. If patient wants to change what they looked like because they never really liked that feature about themself, then I have a long discussion with them about this change. You, @conmama, with your full upper lids since birth is a perfect example of someone who I would have a long discussion about whether you want to keep the full eyelid look after surgery or whether they want a more sculpted, deeper-set eyelid with a higher fold. And actually, if you choose the second option, then I would make sure that you understand that this will change your “look” and possibly change your “identity” and to make sure that you understood what this meant and that you were comfortable with it.</p></li>
<li><p>Surgery should always be planned taking into account a patient’s anatomy, ethnicity, and gender, and patient’s desires of what they want to look like.</p></li>
<li><p>Low set brows: I see pts with low set brows all of the time. I will manually lift them up to decide if I think that they would look better with a brow lift or not, because there are many people with low brows who, when I test lift them manually, do not look better. You also have to be careful because overdone brow lifts are the reason that people have a “surprised” look or look that makes them look like they had obvious surgery. However, there are pts with low brows whereby it’s not really the redundant skin of the eyelids but more of the low brows which are causing the problem and the improvement with blepharoplasty alone will definitely be limited without a brow lift.</p></li>
<li><p>Photoshop: I don’t have photoshop in my office either. I would not judge an office based on this. The benefits is that you have a visual so that I can really understand what the patient wants. The negatives is that your face is not really a computer program. It’s not that exact. If I remove 10 of skin from you, it would look different than if I removed 10 mm of skin from someone else.</p></li>
</ol>
<p>5.“Tissue sparing” blepharoplasty: I design the blepharoplasty depending on pt’s anatomy, ethnicity, and gender, and patient’s desires of what they want to look like. However, in general, I usually preserve the orbicularis and I usually excise the fat. If someone has low brows, then I may remove the orbicularis in order to make the brows go up a little. If pt has a hollowed out look already (fat atrophy), then I do no fat removal. I think that a skeletonized eyelid does not look youthful, so I avoid it. It pt still wants a skeletonized eyelid despite my aesthetic judgment, then I will do it for them. Many oculoplastic surgeons like to preserve the orbicularis so that the pt maintains a good blink and eyelid closure. No, the fat does not hold up the eyebrows, in my opinion.</p>
<ol>
<li><p>If you do not trust the surgeon who did your consult, then move on. Lots of surgeons out there.</p></li>
<li><p>I’m sure that when you meet ASOPRS oculoplastic surgeon WN (who I recommended), his views will be similar to mine. </p></li>
<li><p>If you do not like the frown lines between your eyebrows, then you should try Botox! But wait until after you have your eyelid surgery because it might affect your measurements and brow position.</p></li>
</ol>
<p>Have fun with WN consult. Is the 45 year old oculoplastic surgeon HL??</p>
<p>YoHoYoHo, you are a treasure! :)</p>
<p>Also, I love your screen name. </p>
<p>Why, thank you very much, @consolation :)</p>
<p>deleted</p>
<p>My mom had hers done a few months ago, I will see her at Thanksgiving at my bothers wedding in Ashville and can assess the results then. Mom is in a high end senior community in arizona and this procedure is all the rage. Yohoho, do you happen to know the doc that does this in Surprise AZ? Its almost humorous, all of them taking each other to their appts and giving after care!</p>
<p>Thank you so much again, YoHo. There were 4 surgeons from the large office you provided to me and I went to see RB…he is sort of bald if you go look at his bio, and the only one that was Board certified with ASOPRS, at least that is how I read all their credentials. He had an opening Friday or I would have to wait 6week. I left work early for the appt.</p>
<p>Completely different experience. Never mentioned an eyebrow lift, didn’t think I needed one. From my desires, he said all I really needed was skin removal, had me close my eyes and pinched that small fold of skin that is visible even with my eyes open. Had me open my eyes so he could see. Said he works with a scalpel, not a laser. He said I didn’t need muscle or fat taken for the outcome I wanted. He didn’t think I had low set eyebrows.</p>
<p>He didn’t try to talk me into a Lower bleph either. Once I sort of pulled the upper eyelid skin to make it smooth and he said that would be more of a brow lift. I said that’s not what I want, and he said he knew. It would change my look, but at another time if I wanted that I could. He said that he knew what I wanted, but it’s like a tailor. Once he gets in there he will do what he needed to do to achieve as close to what I want as he can, but doesn’t use a picture to look at while he’s working.</p>
<p>He said he does more eye surgeries for medical procedures than cosmetic but the Blephs overlap. I think he meant he does the Blephs while he’s doing real eye surgeries. He seemed quite calm, and I liked his whole demeanor.</p>
<p>I will take your advice to put off the Botox until after surgery. He did say he thought no more than 15 units for my frown lines if I do want that. I really liked how he listened to what I liked and will just do that…not telling me I’d be back in a year because I didn’t do the brow lift like the cosmetic surgeon said.</p>
<p>He did show me how far the scar would extend…further than what I though…I hate that. But, he said that it would disappear in about 3 months.</p>
<p>I forgot to ask to see before and after pics of patients he’s done, do you think that is worth it, since we are all different.</p>
<p>I have another appt. with the 65 year old…WN…I suppose I should see him, too…just to compare. That picture on his website makes him look 20 years younger. But I know pros are busy and not worry about stuff like that. My DH is an attorney and I think had his original pic up for like 15 years…haha.</p>
<p>Thank you again for insisting on the oculopastic surgeon, how you deal with patients and telling me to hold off on Botox…I was going to forge ahead with that in a couple weeks. Cheers!</p>
<p>conmama, sounds like you are moving forward! Good luck with your consult with the older fellow. It will be interesting to see and hear if he makes different recommendations, and who you are more comfortable with.</p>
<p>Conmama, this sounds MUCH better. </p>
<p>
</p>
<p>I think that what he meant is that blephs are done for both reasons. 
Even a bleph like mine, which was deemed necessary by insurance, was done partly for cosmetic reasons.</p>
<p>My surgeon showed me before and after pictures just to illustrate what the procedure could do, in terms of results. Not to say “you are going to look like this.” </p>
<p>So do you think I should call back to his office and ask if I can see before and after of cosmetic procedures he has done? Conolation…how does the scar look now that extends from the corner of the eye, since yours has been about 3months?</p>
<p>@conmama,
It IS important to extend the incision as far out laterally as needed to remove the redundant skin. Some surgeons will only make the incision just to the lateral canthus (the V where your upper and lower eyelid come together), but if your redundant skin truly extends past that area and you only make the incision to the lateral canthus, then postop you have these extra flaps of skin outside of the lateral canthus. The incision that extends far out will heal and you won’t see a scar. And the best part is that you won’t have the extra “flaps” of skin laterally.</p>
<p>Although I do not use photoshop, I do hang my photo of the pt in the OR and, if needed, a photo of the pt 20 or so years ago in the OR which reminds me of what to strive for (if the pt has specific requests) and to remind me of what small facial asymmetry the pt has. But each surgeon is different.</p>
<p>As for before and after pictures, I have them on my website and pts just love them. But realistically, it takes a while to review and post them so I wouldn’t fault any MD who does not have pre and post op photos available.</p>
<p>Glad you had a good experience at that group oculoplastic office. RB is not the only ASOPRS person there; all of the MDs are ASOPRS.
FYI, although WN is 65, he actually looks much younger in person. You will be surprised.</p>
<p>@GA2012mom,
Best place to look will be on the ASOPRS website
<a href=“http://www.asoprs.org/i4a/pages/index.cfm?pageid=3504”>http://www.asoprs.org/i4a/pages/index.cfm?pageid=3504</a>
to find an oculoplastic surgeon near Surprise AZ</p>
<p>@YoHoYoHo …your posts are always so reassuring. Thanks for taking the time to explain the purpose for the incision extending past the V and that it will fade. I do wish he said that he kept a pic in the OR room. I didn’t know that you knew or had met WN…makes me feel better. My appt with him is in 2 weeks. I’ll report back after that. He looks quite handsome on his website. 
I’m feeling better and better with the thought of going through with this and that’s mainly due to you! I know I keep thanking you! </p>
<p>Most of us ASOPRS people know each other. I’m glad that you are feeling more comfortable. </p>
<p>Bookmarking this thread for future reference. @YoHoYoHo, your kindness in sharing your expertise on this subject is is amazing!</p>
<p>@bogibogi, it truly is. It makes me feel bad asking all of these questions, which I know YoHo is doing out of kindness. I’m starting to feel a bit guilty, actually, since I know the consultation charges from what I’m paying these other doctors. I’m getting more valuable info from her!!!</p>
<p>@consolation…before or after you had your Bleph, did you find any online support or forum groups to discuss this with? I’ve tried looking on the internet and I see ones that seem to be a few years old. To be honest, this just scares me as I’m sure it does everyone else. I wonder if my eyes are that bad enough to go thru the 3-6 weeks of post-op stuff…and I second guess myself if it will really make a difference. I took close up pics of my eyes with and without makeup yesterday afternoon to put up here on the boards for youall to see…but I don’t know if we are able to attach stuff here or not? I’m not sure how. </p>
<p>What I find frustrating is not having anyone IRL to talk to. One of my best friends is totally against any elective surgery, so she’s out until I get ready to do it and come clean. I have another friend who would be supportive, as I know she would like to have a necklift and doesn’t like aging, but she’s a blabbermouth. I’m afraid if I just tell my closer friends, they would all tell me I look just FINE and why would i go thru that to just look “refreshed” (and I hope that’s how I end up just looking with no side effects!). </p>
<p>Did you second guess yourself alot when coming to this decision…or was your medical issue enough that you didn’t. That’s sort of why I have been looking for an online support group…people who have or are thinking about it to commisserate with. It’s really on my mind all the time, and I’m constantly looking at my eyes…pulling up the skin, looking at old pictures. I looked at a photo from exactly 2007 (only 7 years ago!) and I was quite happy with my eyes then. I know if I have this done people will say “you don’t look any different”, because they see me all the time and it’s not horrendous yet…but I see the “tired” look and actually my husband agrees.</p>
<p>I actually have 3 weeks that I can take off of work in December! I was telling DH how I will feel self conscious everyone at work knowing and he said after 3 weeks and wearing my glasses, no one would probably even know. Most of the time I’m just at my desk anyway. </p>
<p>No, the only people I talked to about it were the people on this thread. I definitely didn’t second-guess myself: I couldn’t wait to get it done! But I was much worse off than you, obviously.</p>
<p>One poster shares photos here on a Flickr group, but obviously you have to be careful to make it private.</p>
<p>@conmama, you don’t need to talk to anyone IRL. If your “friends” are going to have issues with it, just don’t tell them. Don’t worry about what other people think. If you want to do this and if you will feel good about yourself after you’ve had it done, then go ahead. I applaud you. I don’t think you’ll have any regrets.</p>
<p>(I joked for years that when I turned 40, I would get my eyes done. Well, now I’m about to turn 66 and I still haven’t had it done. But now I really, really want to. Just concerned about the cost, as we are sort of holding our breath until I’m 70 and I start taking Social Security.)</p>