Linda-
I have to agree with the information that the other surgeons have provided. I recommend a levator advancement only when I make the diagnosis of ptosis...this is made using a functional analysis of your eyelids function. Occassionally, one eyelid functions better or worse than the other and can make the advancement procedure more complex. This may also be covered by insurance as it is a functional impairment that can be quantified objectively by your surgeon.
Men have "bushy" eyebrows and can conceal a direct excision scar...women have thin eyebrows and therefore may form a visible scar over the eyebrow. Plastic surgeons are fanatical about concealing and camoflauging incisions, this is why I typically place brow lift incisions high in the forehead, or better yet occassionally use the same blepharoplasty incision to plexy or lift the brow with either a suture or a tacking device (which desolves over 6-8 weeks).
In the last few years, plastic surgeons have demonstrated via CT scan evidence that eyelid and orbital fat decreases over time, so we are less aggressive with our fat removal. This may be the reason your surgeon has referred to his procedure as sculpting.
I think you need as many opinions as you are comfortable obtaining, face to face, with Board Certified Plastic Surgeons who perform a significant number of Blepharoplasties. Ask for result photos with a focus on patients Before photos that your surgeon indentifies as resembling your own anatomy.
I hope this helps and good luck!
Dr. C
