Bad Results - Upper Bleparoplasty, Will Need Revision Surgery - Scottsdale, AZ

I did lots of research and everything was positive...

I did lots of research and everything was positive. The consult went well and he was very nice and personable, spent a ton of time with me. The procedure was on a Saturday in his office. It seemed to go well. Pain and swelling we're pretty manageable. At home instructions were very clear and I followed them explicitly to the letter.

Dr. Holden - terrible Upper Blepharoplasty result

This is an excerpt from the Dr. that trained Paul K. Holden, regarding placement of incisions:

"Upper Lid Blepharoplasty
It behooves the surgeon to be meticulous in the surgical markings for upper lid blepharoplasty prior to surgery as a difference of 1 to 3 millimeters (mm) from one lid to the next may create noticeable asymmetries. Therefore, the surgical markings for both upper lids are made using a fine tip marker and small calipers. With the patient looking up, the supratarsal crease is identified and measured from the lid margin using small calipers; this denotes the location of the inferior limb of the surgical marking. This measurement ranges from 8-12 mm (10-11 mm in females; 8-9 mm in males). "

Had my incision scars measured today and the worst one measured at 16 mm - a good 4 mm higher than recommended by the person Dr. Holden himself considers brilliant. There was just no reason for Dr. Holden to place my incisions so high or to leave pockets of fat in the corners of my eyes.
Dr. Holden is once again practicing. I would NOT recommend him to my worst enemy.
Phoenix Facial Plastic Surgeon

Dr. Holden told me that my procedure was "textbook" and very typical and easy for him. He's very charming and pleasant. I researched him thoroughly, everything checked out positively. I knew something was wrong within a few weeks because my scars were so high up. He told me that it just appeared that way due to swelling and as it subsided, the incisions would relax and fall into the crease. Two months after my procedure Dr. Holden was arrested on a drug charge and his practice shut down - I never heard from him again. He had a previous arrest and his license had been suspended but the state of AZ did not make this known to the public. You can google him and see all the details of his arrest history. I NEVER would've chosen him to preform surgery on me had I known his history. I will need revisions to correct my scars. I'm out $7500.00, my confidence and self esteem have been hit hard and I can now look forward to going thru the whole process again. The first PS I consulted about a revisions said that "lowering" scars is very difficult and many PS won't even do it or make promises for improvement because it's hard to improve it. He suggested I see someone who does Revision of "botched" procedures and/or an Oculoplastic Surgeon. I will have to go to many, many consults to find someone I can trust again. This will take $$, time and anxiety and I wish I'd never had the surgery with Dr. Holden. I started out with saggy eyelids, but now I have nasty scarred eyelids. I went backwards. I don't know if he'll get to practice again, but if he does, I would not go to him. I feel bad for him and his addiction and problems, but bottom line, he should not do surgery on someone without them knowing he's got an addiction problem and being able to make an informed decision.

1 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
4 out of 5 stars Payment process
4 out of 5 stars Wait tmes
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Comments (31)

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It is very sad, to have noticeable scars after surgery;-( but myself to top it of, I have a scleral show'ectropion' n the indented scars looks like this surgeon was carving my eyelids n even after 11 long years I do still have those noticeable indented scars n the ectropion. Hopefully ur scars go less noticeable. I did go back with this charlatan surgeon of mine to "fix" n he did worse than better, so sometimes it's not good to go with ur previous surgeon.
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Mely, I'm so sorry to hear about your results. I also have scleral show due to poorly done lower lid surgery. Who was your surgeon and where located?
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Eugene Cherney n he is in Des Moines Iowa.^_*;
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You are doing a great service warning others about Dr. Holden. I wish there was a way to stop such doctors from practicing altogether.
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He's back at it and the AZ Medical Board shows no "disciplinary actions" under his info. Apparently you can be arrested for stealing medicinal cocaine and awaiting trial for same and just carry on doing surgery on people. The PS I consulted to see if I could have a revision (who measured my lids with the small caliper) said I was the third Holden patient he's had come in to see him w/ bad results they're hoping to have revised. I also corresponded with a local journalist who's been writing about Dr. Holden, and he said he's had many patients with bad results contact him to thank him for getting the word out.
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I don't think you look bad at all. The scars are slightly noticeable in your photos, but nothing a little makeup couldn't fix. I hope things go well for you. If I met you on the street, I would think you look fine.
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Thank you for saying so, but it's hard to spend your hard-earned money and your time researching and months healing and then look at scars that are not placed in the crease where they should be day in and day out. It is what it is and I have to live with it - but I want others to be able to see this review so they stop and think before using this surgeon. Thanks for your comment.
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I am so sorry you have had to go through this. Have you had any response from the MD? I hope you get a refund or some sort of restitution.
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You've really been through such a tough experience! I had my lower bletharoplasty done one month ago in the UK. Have you tried a silicone gel called Dermitix? It reduced scar tissue very quickly. You can buy it over the counter. It might help! Always worth a try. Good luck x
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I did try one that was recommended by someone else on RS and found it so sticky that I couldn't cover the scars with makeup and my hair would get caught in it. :0 I'll look into Dermatix. Starting in January, I'm going to start doing consults with other PS to see if I can find someone to do a revision. Thank you so much for your kind reply. :)
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Hey 3dogmom, I'm linking your forum post about finding a new surgeon here.  If anyone can recommend a good Oculoplastic Surgeon that does eyelid revisions in AZ or MN please comment either here or in the forum. 

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I'm looking for an oculoplastic surgeon to revise a previous surgery where too much fat was removed on lower lids, causing them to pull down. If anyone has a recommendation for northern California, in the San Jose/Palo Alto area, I'd much appreciate it.
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RE: Revision surgery for upper lid blepharoplasty Patients dissatisfied with results after upper lid surgery (blepharoplasty) should contact their primary surgeon and discuss about the possibility of undergoing revisional surgery. Eyelid surgeons should make sure that their patients understand the healing process of any surgery, including blepharoplasty, usually takes 12 weeks or 3 months. Therefore, revisional surgery before 3 months postoperative shall not be performed. Re-operating in a “moving target” (healing eyelids) could make very difficult to determine the outcome. Scars of upper lid surgery may be visible during the healing process (12 weeks/3 months). This normal post-operative finding usually causes a lot of anxiety on patients. Blepharoplasty surgeons should remind their patients that upper lid surgical scars heal inconspicuously and therefore, there is no need of reoperation before 12 weeks of healing time. Patients with residual excess of skin and or “fat bags” may undergo revisional surgery. These patients should, actually, must contact their primary surgeons about these concerns. It is common for patients to go to another surgeon when things go wrong. However, patients should understand that doctors, like patients, are human beings, and therefore not immune to errors (e.g. if you make a mistake with your daughter/son, do you think It is reasonable for your sibling to find substitute mother/father?). Patients unable to contact their primary blepharoplasty surgeons due to mayor reasons (e.g. medical license suspension, etc.) should consult with a board certified plastic surgeon specialized in upper lid surgery. Patients should also consider asking for permission to get in contact with primary patients of that surgeon that underwent revisional surgery. Surgeons that do not perform revisional surgery on their patients are surgeons not really operate too much.
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You mentioned getting in contact with patients of a surgeon that underwent revisional surgery. I did ask that of one of the doctors I consulted with and he refused. His before/after photos were good. Do you think that a doctor who refuses to let a potential patient contact another patient who had a similar surgery is not a good doctor to go to?
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Doctors that refuse to let a potential patient contact another patient who had similar surgery are not automatically/necessary bad doctors. Surgeons have different ways to run their practices. Some surgeons are more “open” than others in regard of letting the public and potential patients now about his/her complications and revisional surgeries. The main issue with patients seeking revisional surgery is to regain ‘trust’ on the surgeon. Patients may think “If I had a bad outcome with Surgeon A, the same could happen with Surgeon B and Surgeon C. No surgeon does perfect surgery in 100% of his patients. However, patient should be confident that his/her surgeon would take good care of them if things go “not smooth”. For example, I had to re-operate on a patient that had undergone upper lid blepharoplasty for “sleepy eyes” (upper eyelid ptosis). Few days after surgery, once the swelling subsided, one of the eyelids was still low (the stitch “popped”). The patient was of course mad with me. However, I reassured to her that I was going to take care of her. She underwent revisional surgery and now she is extremely happy. She is so happy that she has referred me several patients. Additionally, a patient that underwent both abdominoplasty and facelift with another surgeon and had a bad outcome in both surgeries was very reluctant to trust any surgeon. However, she wanted revisional surgery to regain her self-confidence. This facelift patient contacted my revisional eyelid surgery about undergoing surgery with me. After their conversation, the potential new patient decided to undergo revisional abdominoplasty with me. The patient had an excellent outcome and was extremely happy. Then, after regaining her confidence with the plastic surgeons, she trusted me again to revise her facelift (a bigger deal for her). She is now extremely happy. You should see how overjoyed she is with herself. She has regained her self-confidence. She also has regained confidence in plastic surgeons. In a nutshell, undergoing primary surgery and revisional surgery with a plastic surgeon should be like a marriage: the patient and the surgeon should both work together during both the ‘good times’ and the ‘not really good times’ to achieve the best outcome possible for the patient.
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Thank you for your thoughtful reply. If I go to the surgeon who did the surgery that needs revision (who by the way I do still trust) is it customary to be charged for the revision? My surgeon could feel it's not his fault; on the other hand, I feel it's not my fault because I followed all instructions precisely.
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Just to be clear on this - your comment talks about 3 months/12 wks. I am 7 MONTHS POST-OP. I did not run to another PS a few months post-op, but just recently saw another PS and he was honest enough to say he was not th eright dr. to do my revision . I have no intention of moving forward until/if I find the right doctor. I will however, request info on past revision patients - that's a very good idea. Thank you.
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I think Dr. Mesa means well. However, sometimes I think that surgeons, without meaning to do so, insult the intelligence of their patients. Generally, it is my experience that most patients do trust their surgeon and by and large surgeons do a pretty good job of preparing their patients for the ups and downs of healing after surgery. This includes the reality that somethings are out of the anyones hands and there really are unavoidable complications. These situations may benefit from revisional surgery when things settle down. Provided the course of the surgical outcome and the behavior of the surgeon do not cause patients to rethink this confidence, their primary surgeon is who they will look to for help. However, even if you have a God complex, it is important to understand that this faith in the surgeon is not blind. If you carefully study the photos posted by 3dogmon, you can see that the surgeon has made upper bleph incisions that make absolutely no logical sense. The extend out of the creases in different locations on both sides. In insults that intelligence of our patients to tell them to over look something that was never described to them as a possible outcome. Now things happen, but one has to be naive if you believe that this type of outcome will go unnoticed by a patient. It is that surgical saying that if you tell someone in advance what to expect, it is an explanation; if you say it after the fact it is an excuse. I do a lot of corrective surgery to correct the work of other surgeons. Things do happen and the steps that a surgeon took at the time of surgery might be appropriate and logical. Often it is poor communication after surgery that causes the biggest problems. Let's just say that can be very trying under these circumstances for a patient to hold faith in their surgeon. It is unrealistic to expect them to just be patient and not seek other opinions when things don't feel right. Having your surgeon go to prison surely does not help but 3dogmom has a real issue that may or may not resolve to her satisfaction and may very well require a revision. Regarding connecting a potential patient with an old patient, I agree that there are very good reasons not to do this. First, we tend to rely on only our happiest and most devoted patients for this. Is this really the best representation for a potential patient? It is somewhat like digital imaging. Of course you are going to show the best possible outcome as the "hypothetical" after image. How representative will that be of the actual work? One of the reasons I stopped connecting potential patients with existing patients, it that I experienced two situations where the potential patient basically turned into a cyberstalker with inappropriate contact that became very uncomfortable with my patient. Nothing serious happened but I decided that we really don't live in small towns any more, and this seemingly innocuous act can undermine patient privacy in ways that are hard to anticipate. Their are alternative ways of patients to reach out to a surgeon's existing patients. This website offers one of those paths.
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Thank you, Dr. Steinsapir, very well explained and well-said. I wasn't looking for perfect by any means. But it's pretty clear that I do not look like someone who had a successful upper blepharoplasty. I understand things happen and I'm not an unreasonable person. Like many women, I wanted to feel better about myself and choosing PS is a serious and (usually) well-thought out decision. I had hoped this was a PS that I would have a long history with and my friend and I even discussed that if things went well, we'd have mid-face lifts with him in a couple years. Anyway, thank you for validating that I'm not just whining over a little imperfection. I spent all summer having people look directly at my right eye and ask me "what happened?" Not exactly the "you looks so refreshed" response I was looking for. I am just hoping there's a way to improve it - even 50% would be great at this point. Thank you again! And thanks all who responded with kind words of support.
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This is a very discouraging story. I agree that you have awful scars. However, I would not be in a hurry to have these revised. The scars will continue to fade and by 12 months they will be relatively inconspicuous. The chemistry of confidence with your surgeon is what is needed to carry a patient to complete healing which can take a full year. Your surgeon's criminal behavior has robbed your confidence in your ultimate surgical outcome. Try to separate your feelings about your surgeons behavior from your eyelid result. Don't make yourself have a surgical revision out of a need to purge yourself of an association with your former surgeon. It is reasonable to get second opinions but also give yourself time to heal before deciding if more surgery is necessary.
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Dr. Steinsapir, thank you for your kind and encouraging reply. Everyone told me wait 6 months and you'll see such a big difference. Well 7 mons have come and passed and it's not better. I didn't even know about my surgeon's arrest until I just recently tried to call and schedule a follow up. Since I am now back in AZ for the winter and wanted to see what he would think of my result and/or if he would suggest some sort of revision, if not by him than by another PS. I could not reach him, website was down and upon searching - I found out why. I was in tears and wanted to be sick at the same time. I now knew why he stopped answering messages back in July. I do agree, perhaps I should wait 5 more months and then I can at least now I gave it time and can feel justified in a revision. I waiting many years to take the step of a blepharoplasty, I guess I'll have to wait a few more months to hopefully, get to a happy ending.
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Dr. Steinsapir does make some very good points, I hope that what he had to say gives you some comfort and hope. Time is our friend sometimes- but, boy, the waiting is not easy, is it!!
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You can say that again! Sorry for all the grammatical errors. Don't know where my fingers were on the keys I guess. :)
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So skrry. If it's any consolation, i think you do look much better overall after the surgery.
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I'm sorry to hear about your problem it scandalous he was still allowed to practice. Your scars will fade more really it doesn't look bad. I have a similar situation, although I didn't do my research and thought I was in good hands, its a doctor right. I had a upper bleph December 2012, what a disaster, the surgeon took too much skin and left me with uneven eyes and a huge scar way above my natural crease on one eye. This surgeon was not at all skilled and did not have any positive review online, which of course I found out to late. I visited another surgeon for a consultation to do a revision but unfortunately there isn't enough skin to work with so he can only try and tidy up fat pockets that still remain in the corner of my eyes. I am having my revision December 4th 2013 and the new surgeon who i feel so comfortable with is going to laser the prominent rope like scar and hopefully it wont be so noticeable, I am also having a lower bleph and fat transfer done. I feel way more comfortable this time. I didn't do my research last time and Paid the price.
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