Diagnosing brow ptosis and dermatochalasis

Question

Hi, Is diagnosing brow ptosis and dermatochalasis as a eye specialist surgeon typically straightforward for an expert in this area. Kind regards

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct excess upper eyelid skin, depending on the situation.

For less significant upper eyelid skin excess or more mild improvement, there are nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if the hooded eyelids have more excess skin present.

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Mats Hagstrom, MD (license on probation) · Answer

When it comes to plastic surgery, there is nothing that is Easy or straightforward.
There are major differences in approach, view, philosophy, and surgical skill among providers.
Plastic surgery outcomes are generally based onto variables.
Sometimes there are other factors to consider, but generally, I’ve promised our based on patient candidacy and the skill of the provider repaired
Understanding your own candidacy for various procedures is an important part of the process and maintaining high patient satisfaction.
Not everybody who seeks or has plastic surgery is an ideal candidate.
Likewise, not all plastic surgeons whether specialist or not are excellent. Most plastic surgeons are merely average.
To find exceptional providers requires finding those who excel at their field.
Understanding your own candidacy is best done through having quality in person consultations.
In person consultations is also the best way to vet providers and find the right provider for your needs.
I generally recommend people consider having multiple consultations interviewing different providers before selecting a surgeon.
Provider selection is by far the most important variable since it’s the only variable patients really have control over.
For facial procedures, get a set of quality facial pictures to use as a reference during consultations.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had very similar facial characteristics to your own.
 Learn to differentiate what quality results look like and learn to understand your own candidacy for these procedures.
There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely you are to find the better provider for your needs.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
Scheduling only one consultation, more or less eliminates the ability to choose a better provider.
The second biggest mistake I see patients make us assuming that a board certified plastic surgeon With a handful of positive reviews, and a few years of experience has mastered most plastic surgical procedures.
When patients take ownership of the vetting process and learn to interview plastic surgeons correctly, the chance of having positive outcomes goes up dramatically.
Most people did not have experience consulting with plastic surgeons.
Plastic surgeons on the other hand have years of experience giving consultations.
Having multiple consultations generally makes patients better consumers and gives patients the ability to properly vet providers in a more successful manner.
The procedures you are contemplating are permanent and irreversible.
The time to be critical of the plastic surgeons is during the vetting process while consulting with providers.
Good luck,
Mats Hagstrom MD

Diagnosing brow ptosis and dermatochalasis

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