Finally Scheduled Consults for my Droopy Uppers, Puffy Lowers and Ptosis Repair - Tucson, AZ

I wanted to share my consultation experiences as I...

I wanted to share my consultation experiences as I begin this journey. I need "total" facial rejuvenation, however my eyes bother me most, but need more than just cosmetic work. I also have functional issues that involve work that many facial plastic surgeons don't usually do so likely need to be done by an ocular plastic surgeon. Revisions are very complicated so I only want to do this once. Have pondered this for a while (have wanted my eyes done for over 10 years), wondering if I should make this investment in me, and Yes! I should! Finally have 2 consults scheduled for this week! Nervous but very excited to finally get the ball rolling, I think it will make such a difference :) Found 2 well qualified surgeons in my area, see 1 tomorrow afternoon and the other on Thursday.

Some before pics

Had first consult, will update later. Interesting process though, on several levels :)

My first consult was with Dr Lo in Tucson

So, where to start. Was very nervous and almost felt embarrassed to be doing this. Weird I know, story of my life :/ Beautiful facilities, very upscale and very nice staff. Was taken into a little sitting room with a couch, two leather chairs and a computer. Talked to the nurse and she set me up with an online account right there so I can view more pictures, and got specifics about why I was there. I told her functional (ptosis) and cosmetic eyelid surgery, and that I intended to do full facial rejuvenation (as much as is financially feasible anyway). She left and I looked at pics on the computer and saved some to my account that I liked. Very soon Dr Lo came in and shook my hand, very personable and low key, comfortable to talk to. He looked at my eyes, lifted my upper lids, showed me how to lift my lids without raising my brows (that was an "eye opener" hehe). I showed him 2 pics of my eyes at 11 yo and 30 yo to show I always had droopy eyes. He examined them and complimented me for thinking to bring them :). We discussed the eye surgery, then facelifts. He does a "quicklift" which I had seen on his website. Docs here already said I needed the full lift, nothing quick, lite or weekend, lol. He said his quicklift is the full thing with muscle tightening etc. Not sure how I feel about that after what I've read here.. going to continue so I can divide this up some...

Dr Lo Consult, Details

Dr Lo stated he had about a 5% redo rate on ptosis surgery, and that mine was very mild (I think it's better than it used to be) I told him I do eyelid exercises and he laughed lol, and said they don't work. He was very confident that he could fix my lazy eyes (one more than the other) and that I would be unpresentable for about 1 week, and it would take close to 3 months for complete healing. He could give me an upper lid approx the size of when I was 25-30 (picture), but I might still need filler in my undereye after :( because he doesn't move fat, just trims it conservatively.

Oh, and I mentioned I was doing consults and he asked if I was seeing Dr Duerkson (seeing her today lol). He said they were friends (I think, acquaintances anyway lol) and that she's very good. Could have been awkward, but wasn't. Yay.. hehe

His comments re the facelift (quicklift), I have firm, wrinkle free thick skin, therefore I won't get as much lift in the neck/chin/jowls as someone with thinner more damaged skin. What!!?? He showed me pics to demonstrate. This made no sense and was definitely NOT what I wanted to hear. Since I've taken great care of my skin I get less result from a facelift? ugh! Oh, and he doesn't use general anesthesia. For the eyes you have to be able to blink, etc (scary!), for the facelift he uses an anesthesiologist and IV sedation, basically asleep and numb. For facelift said would be significant bruising etc for about 3 weeks and showed me where the incisions would be, looks like regular facelift incisions, in front and behind the ear and into the hairline.

After he left, the nurse came in and had estimates for me, for with and without the facelift. The eyes were more than I expected, the total with facelift was less. The price is good for 90 days. If I want to schedule with him I need to come in for a pre op (4 weeks ahead is what they like, to get you properly ready with skin, take your pre op pics, etc), and you make a deposit (didn't ask how much). They take CareCredit with 60 days no interest. The money part was very straightforward and comfortable.

Pros:
I like him and his facility and the nurse I spoke to
They were on time
I liked having access to the computer pictures, etc
I think he is very competent to do my eye surgery
Very nice facility, confidence inspiring
He was confident in a nonassuming way
Felt very honest and trustworthy, super important!
The financial part was a pleasant surprise
He is very conservative
Consult was complimentary
He tightens the platysma (sp?)
He spent a lot of time with me, answering questions I asked (I didn't ask that many imo)

Cons
He didn't tell me what I wanted to hear :( (lol) This is why I'm going to another one today..
We have different "visons" of my face I think
He doesn't do fat repositioning
He doesn't recommend fat transfer, just continued filler... ugh (they do it if patients want though)
He doesn't think I can get complete correction of jowls, etc (lower face)
I didn't get the impression that there was any customizing of procedures for me, maybe I need to lower my expectations (not happening...)
Didn't tell me what kind of ptosis procedure he would do, a doc on here rec several, was looking for some terms I didn't hear...
Not really clear on the facility, but I didn't ask

Will add more if I think of it. Hope this is helpful. Happy to answer any questions :)

Seeing Dr Duerkson this afternoon.

The pics I took to the consult

Second consult

With Dr Kathleen Duerkson. She was my first choice for eyes. Why? Interesting story... About 10 years ago I decided I wanted to get my eyes done and maybe some lipo under my chin (same thing I want now... hmm?) So went on consult with a very well thought of female PS in town. During that consult, she had lots of plans besides what I wanted, including neck lift, laser resurfacing, etc. which I wasn't ready for (am now) but what was real interesting, is she wanted to have Dr Duerkson do my eyes. Quite a recommendation imo.

So office was easy to find and very nice and pleasant. Short wait and I was called back to the room with her assistant (forgot her name). We went over all the papers I had filled out at home re meds, health issues, fam history ect. She also checked my vision. She was very pleasant and attractive. After a very brief wait Dr Duerkson came in. She looked at the pictures I brought and examined my eyes. She seemed to think they were better than previously and that I don't have ptosis, but "pseudoptosis"? Interesting. Told me what she would do to my eyes, while I held the mirror. Drew on a diagram of the eye to show me how the fat herniates and why she would do what she planned. For the lowers she would cut outside the lashes, trim the fat slightly and remove a little skin. In order for the eye shape to stay the same (and the lower lid to stay tight) the incision and stitching extends beyond the eyelid, in a natural crease that I guess disappears? Since botox I have no more lines there so... She says this tightens the lid sufficiently that I would prob not need any more filler etc.

I asked about facelifting. She thinks after the eyes are done I will be happy :/ Sigh...

She thinks just some filler after is all I need. I pointed to my double chin. She said maybe some lipo there. Sounded good to me.

Doesn't do fat transfer. Not predictable enough. I have heard this before... Of course filler keeps patients coming in regularly I'm thinking. Another sigh.

She takes me in to see the other lady whose name I forgot. Very nice. She's getting her eyes done soon lol. She showed me a photo album of patients who got chin lipo. Wrote out estimates (?) for with and without the lipo. Again, quite reasonable. They need doctor clearance and blood work. If indicated would need an EKG but not in my case. She does her surgeries at three different surgery centers in town, but only one of them is equipped for the lipo (the furthest one).

If I decide to go with her, I just call and pay $100 to schedule a date. And the surgery center fee and anesthesia fees are paid separately. A very pleasant and informative experience.

But I'm not done ;)

2 more consults scheduled..

Mulling over Dr Duerkson's opinion that I only need upper and lower bleph, thinking maybe my eye surgery won't be as complicated as I feared. With that in mind I scheduled 2 more consults with well qualified plastic surgeons that are not eye specialists. The first one is the doc I saw about 10 years ago and didn't follow through with (who was going to have my eyes done by Duerkson..) Saw a FB message for a free consult, scheduled for Sept 10th. Second doc I found on here, he's local and I like what I read here and on his website and the consult is free when I mentioned RS. lol That one is scheduled for Sept 29, but I'm on the list to call if they get a cancellation.

I almost feel like I'm shopping till I hear what I want? idk..

Maybe should start review in the Facelift section since I'm doing consults for that next... What do you think? Thanks for listening lol

Plastic surgery mistakes no one talks about

Just saw this and wanted to put it somewhere, can't add info really to our profile

http://www.totalbeauty.com/content/gallery/plastic-surgery-risks

More... 10 things plastic surgeons won’t tell you

http://www.marketwatch.com/story/10-things-plastic-surgeons-wont-tell-you-2013-11-01

Just wanted to consolidate and save some info here. I'm sure we all know that cosmetic surgery isn't all rainbows and lollipops..

Another good read ..

Adventures in Facial Rejuvenation... (Botox, FIllers and Comb Therapies)

It's pretty medical/technical, but I enjoy that.

http://journals.lww.com/plasreconsurg/documents/updates_in_aesthetic_surgery_0512_article.17.pdf

Good info on Facial Fat Grafting

If anyone is interested ;) Even a research study.

http://www.exploreplasticsurgery.com/tag/facial-fat-injections/

Third consult this afternoon

With Dr Gwen Maxwell in Tucson. I saw her once before, about 10 years ago, and she has before and afters. We may be on the same page now lol. Should be interesting. Will update after. Thanks for reading :)

oops

That should have said she has "MY" before and afters (from 10-11 years ago). Maybe that was implied?

Third consult went well...

This week I had a consult with Dr Gwen Maxwell, here in Tucson. I previously consulted with her about my eyes over 11 years ago. Didn't follow through though. She has moved and is closer to my home now, very nice office and I can't say enough good things about her staff. I only saw women and they were so warm and welcoming, even hugged me, the doc included. Never experienced that before, was kinda nice.

I waited less than 10 minutes and Jody, the dr assistant took me back and we talked for a few minutes about health and expectations. After we went to the photo booth and took quite a few pictures I was taken to a cozy consult room to wait for a couple mins for Dr Maxwell. She came in less than 5 mins and was very warm and welcoming. She seemed to remember me but was confused about what we did (nothing, cuz I didn't come back...)

There were 2 color, high def 8x10's of my face (one was just eyes) laid on the table, with a mirror next to me, and she asked me what bothered me. I said eyes, sag around mouth, neck/double chin area. She talked some about my particular features (good skin, heavy neck, asymmetry, ect) and showed me similar in her before and after books. Interesting note, I have *one* friend/acquaintance who has had "work done" but I didn't get the doctors name. Yep, saw her in there LOL.

Dr Maxwell then bagan describing what she could do, and drawing on my photos where incisions would be and how tight my chin/neck would be etc. We are def on the same page as to what would really make a difference: upper (skin removal and minor fat removal) and lower (transconjunctival) blephs (fat removal only no ptosis repair), full face/neck lift (SMAS it sounded like, forgot to ask, not sure she thought I would know what all this was?) defatting of neck, tightening of skin (obviously) which would give major correction to mouth area, laser under lower eyes to tighten skin and fat grafting/transfer to eye and mouth area. Forgot to ask if that included temples? Would also include general anesthesia and overnight stay and take approx 6-7 hours.

Dr Maxwell spent about an hour with me and I liked what I heard. I felt pretty confident that we have the same vision for my face and that she can deliver what she offered. The price was good I thought for all that it included.

PS

She said I really need to lose some weight :/ haha I know, and I have and am. I can actually see improvement in my face and neck after losing less than 10 lbs. I hope to loose maybe another 15 before I actually have this done, I think I will have a nicer result and thus be happier.

My mom had an extended illness and died a year ago in April. She was in another state and with all the travel and caretaking and grief, I just let myself go. Stopped going to the gym, eating right, all that stuff we should do, and I put on quite a few pounds (always been easy for my to gain unfortunately). So I was already on the right track, she wasn't telling me anything I didn't know already, but she seemed slightly uncomfortable saying it... ;)
Mikel Lo or Kathleen Duerkson

My consult on Wed is with Mikel Lo, on Thursday is with Kathleen Duerkson, both are oculoplastic surgeons in Tucson. I will update after my consults.

Was this review helpful? 3 others found this helpful

Comments (35)

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Good luck with your search .... I low you patiently doing your reach and consultations ... Profile is very interested and information ... Thank you
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For mild ptosis, maybe some eye drops can help out
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Drops?
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Try Naphcon Allgery
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That is drops for dry eyes.
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:))
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So, how did the consult go? Have you made a decision yet?
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With insurance, I have learned it is all with the proper coding that the doctor sends in that states medical and not cosmetic. I have researched that depending on your approach with the doctor we can get many things covered. With proper documentation and coding anything is possible. Good luck in your journey...
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That may be true, but it's a matter of ethics.
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Yes it is but hers is also medical. I'm in the medical field and have seen how something bothering a pt may not be high on the importance scale for the physician and can fall through the cracks to later become an even larger problem. I'm never afraid to tell any pt to seek a second opinion. And to have them later come Thank me because the second doctor took more time or did more investigation and resolved the problem with "ethical" insurance coverage. Insurance is suppose to be there for the pt it has been abused so much that they are allowed to be lax in coverage and requiring the pt to jump through hoops because the doctors don't have time to argue back and forth with them.
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All the docs I've seen told me my ptosis wasn't bad enough to be medical. And the doc I think highest of (oculoplastics doc) said she didn't think it was ptosis, just my anatomy. So, I'm not worrying about that now.
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I have been reading a lot about the lower blephs and from what I am gathering most docs recommend not cutting below the eyelash line because of the possible problem with lid retraction.
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Can you add before and after crow's feet using the botox? How many units? I tried a little and it didn't work for me. Maybe more units? I love it on my forehead. 20 units in between my eyes and about 12 on my upper forehead. i don't do above eyebrows because i'm afraid they will drop and i don't want to have droopy lids back. i have deep lines above my eyebrows towards the temple and my crows feet look just like your when i smile.
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My upper eye lids have just recently started to fall (freaking 40s!!). I've read and dr told me you can use Botox to lift your eye lids. Have you tried that? If so, did it work?
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I have only had botox on my lateral eyes (crowsfeet) and it worked fabulously :) I have read that it can be used to lift the outer "wing" part of the brow when injected precisely. If injected improperly it can cause more droop, so gotta have an excellent injector. I have droopy mouth corners and have recently read about injecting botox there, in the DAO area, that it sometimes helps. Hate the downturned mouth corners ugh :( And 40's? I remember them fondly... LOL
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Thanks for info i love fillers.
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I feel more comfortable using an oculoplastic surgeon for the upper and lower blepharoplasty. When that's all healed, I'll reassess and determine how much more work I really need done. Then, I'll find someone who specializes in that area. Just saying...
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I feel the same way, thus my two consults with oculoplastic surgeons. Just not sure I'm "feeling it" with them tho... Both implied I would need filler under eye after, would love to get away from that, and haven't even tried it in that area yet... :/
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Ssouthern, Fat transfer frequently absorbs unevenly. Also if done during a lift can't be placed on the lateral face where, in youth, our natural fat fills out and contours the whole face not just the front aspect of the cheeks. For these reasons Fat, ironically, creates a need for filler just to even out the aesthetic result. So while fat might mean less filler it very often doesn't eliminate the need for it. Just sayin.....grace
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grace, you are absolutely right, I had kinda forgotten about that part. Not sure there is anyone in the area who is considered "excellent" for FT. Dr Durkson mentioned if I really wanted someone good for the fat (I was all ears, thought she meant local) I could go see Dr Coleman. In New York :/ Um, yea... I've heard of him lol. I don't have that kinda budget...
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Very informative&descriptive review. Felt like I was there with you. Chin lipo does work,I had it done when i was 25&it worked well because now@43 no jowls or wrinkles. Best wishes on your ps&whatever you decide.
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Thanks! I wanted submental lipo 10 years ago haha.. I am kinda worried it won't be enough though? My lower face is pretty "full". Feels like all my fat just slid down...
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Maybe you just don't need it :) Stick it fillers or not and Enjoy your beauty. It just might not be your time yet,you know they say timing is everything. It took me 5 years just to do smart-lipo on my arms. This is your face so definitely be cautious and aware of pros&cons. No matter what you decide for yourself,i wish you well. Enjoy this 3 day weekend.
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SSouthern...Boy were you thorough! great job with the questions and summary. Your review is going to help a lot of folks just starting the "thinking through" process. grace
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Organizing my thoughts this way is really helping me with my thought processes. Thanks for reading my ramblings lol
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