What are surgeons’ policies or attitude towards minor revisions following Blepharoplasty? Does the opinion or preference of the patient matter, or is it strictly up to the surgeon to assess what is worth correcting? Do most surgeon's charge for such corrections, or is it included in the initial fee?
Minor Corrections Following Blepharoplasty
Doctor Answers 8
Best to discuss policy prior to surgery
If there is an obvious correction that needs to made, it is our policy to waive any surgeon's fee for the patient. However, if the "correction" is unrealistic or if the outcome is one that was discussed as a possibility prior to the original operation, then any further procedures are the responsibility of the patient. There really is no rule or policy to which all surgeons agree. Good luck.
Policy on Revisions and Complications
Usually patients sign a contract prior to their surgery spelling out who is responsible for what.
There is a grey zone when the patient thinks something should be done but the doctor does not feel it is in the patient's best interest, or would aesthetically damaging, or too risky to justify doing surgery.
Examples are a patient who wants more skin taken from below the eyes after a blepharoplasty, when the surgeon knows it will pull down in a strange or unusual fashion, or a facelift patient who wants more tightness but the surgeon knows it will create a windblown look.
In those cases, it is best to discuss what the patient's wishes are, what the surgeon is capable of safely doing, and almost always there will be a meeting of the minds.
Most top plastic surgeons are very customer service oriented and want to make their patients happy... within responsible limits.
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Revisions are for residual fat or excess skin
Minor corrections after blepharoplasty are usually performed if there is residual fat or excess skin on the upper or lower lids. If there is excess fat, this is usually removed under a general anesthesia since it is painful to remove it under local anesthesia. The monetary charge for corrections is usually fairly minimal and usually just covers the operating room for anesthesia, in our practice.
Up to the surgeon
I always find this question interesting. Not because of the patients response but because of the surgeon's response. All surgeons have their own policies regarding this issue that should have been addressed with you prior to your surgery.
I tend to be a perfectionist. If I have a patient that is unhappy with their result for any reason, within the first year, then I guarantee you I'm not going to be happy with their result. Hopefully, your surgeon has as much of a critical eye. I'll revise the surgery without fee but the OR and anesthesia fee is up to the patient. Other surgeons don't see it this way (I'm dealing with a surgeon for my mother-in-law for just this issue). Perhaps they think it's the patient's fault for the result.
Long and short is that there is no concrete policy but if the surgeon has any self respect about the results that are seen in public he/she should consider their revision policy.
Touch-up or Revision Blepharoplasty Policy
As a surgeon I attempt to produce beautiful results and happy patients. However I often tell patients that surgery is imperfect. Trying to reduce or eliminate a small but visible eyelid irregularity may be technically difficult and carry risks disproportionate to the possible improvement. Your surgeon must assess that independently. I would expect him or her to carefully consider and discuss your desires.
My office provides all patients with a quote during their preop consultation that spells out our policies about redo surgery and which items the surgeon will discount, and which items the patient would be responsible for. Patients know this before agreeing to initial surgery.
In general surgery does not come with a warranty of patient satisfaction or guarantee of a specific result. You should not expect another surgery "for free." Of course as a surgeon I would want my patient to have the best final outcome with the least risk and expense.
Revisions are in the eye of the beholder.
The opinion of the patient does matter. However, it is human nature to what more and better. Consequently, patients are often told that they will have to pay something toward the cost of revisional surgery. Policies among surgeons vary and the exact issue also has some bearing.
To me, if a patient has had an aesthetic improvement but wants a more dramatic effect, they will be asked to pay for the cost of anesthesia and the facility, and generally, a portion of the surgeons fee.
Occasionally, there is some post operative issue. It might be that the incision did not heal ideally or separated while healing. Their might be residual fullness in the eyelid that is beyond an aesthetic issue. Under these circumstances, I often will revise the eyelid at no charge to my patient. I think this approach is very common with other surgeons as well.
Obviously, it is possible that the patient and the surgeon are not on the same page. The patient might feel that surgery was very disappointing and yet the surgeon may feel that the result is very acceptable and that the patient just has "unrealistic expectations." On more that one occasion, this has been the basis for a permanent break down in a relationship between the surgeon and the patient.
I think that most surgeons are motivate to make their patients happy but recognize that there are limits. If there is no meeting of the minds, then it is probably best to look elsewhere for further aesthetic help. In the process of looking for a new surgeon, it pays to avoid bad mouthing your first surgeon because this will definitely make the new surgeon uncomfortable. It is unavoidable for them to think that it is just a matter of time before you may be talking to another surgeon the same way about them.
Cosmetic surgery should always be a collaboration
The decision to perform cosmetic surgery should always be collaborative. By definition, this is an elective procedure so a surgeon shouldn't talk you into surgery. However, he may or may not agree with your assessment of the esthetics of your eyes and may or may not feel convinced or comfortable about a procedure making you happy or solving the problem. Unless there is a functional problem, you and your surgeon have to be in sync. If you aren't, go seek a second or third opinion. As far as revisions, there is no standard although most surgeons will want to insure that you are a happy patient. Most financial issues with post-op complications or revision should have been addressed prior to your original surgery. Small revisions performed under local in the office might be done gratis (though not always) while more involved revisions requiring an operating room and anesthesia and initiated because of patient's "taste" rather than a surgical mishap, might fall completely on the patient's shoulders. Cosmetic surgery is never truly guaranteed.