How Can I Communicate With My Blepharoplasty Surgeon So There are No Aesthetic Surprises Post-Op?

I am 53 with quite a lot of excess skin and hooding on upper eyes. I want as "natural" a result as possible, no dramatic change, hollow or round eyes and no "surprised" look. I've communicated this to dr. What other type of direction should I give: I don't know what else is at her discretion. If there are choices she's making in terms of eye shape/final result, I want to know what "choices" there are so i can be specific about my desires. Thanks for your help.

Doctor Answers 12

You are in trouble.

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Relying on telling your doctor you don't want the surprised look is not going to get the result you are looking for.  This statement is nonspecific.  If eyelid surgeons really new what they were doing, no one would have the surprised look.  Usually the issue is the surgeon dismisses this type of concern and does the surgery they always do.  So look at your surgeon's before and after pictures.  Provided your surgeon actually did these surgeries this should give you an idea of their very best work.  If these patients have the surprised look, don't be surprised if you end up this this look as well at the hands of this surgeon.

I would recommend seeing additional surgeons as well. (Hint: being on TV does not make one a great surgeon!).    Fortunately NY City has a number of excellent eyelid surgeons.  The American Society of Ophthalmic Plastic and Reconstructive Surgery maintains a website of highly qualified eyelid surgeons (

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Natural Look after Eyelid Surgery

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Does your surgeon understand you?  There are two types: There are the ones that learned a procedure during their residency that they are very comfortable doing, and they do it for everyone.  And there are others that look to understand the why's of aging changes as they appear on an individual, and address them accordingly.

For instance, you might get a more natural result by staying away from eyelid surgery alltogether, and instead receive fat transfer or fillers to your brow area to get rid of the hooding.  Does your doctor tell you she knows exactly what you mean, and then go on to elaborate?  Does she ask you for old photos to see how you looked when you were in your early 20's, or are you just going to get the standard blepharoplasty?

Be careful, because the first surgery should be your last.  If there is a problem, or you are not happy, it is much more difficult, if not impossible, to fix afterwards.

Yoash R. Enzer, MD

Yoash R. Enzer, MD, FACS
Providence Oculoplastic Surgeon

Communicating with your surgeon about your desired blepharoplasty results

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It sounds like you've given your surgeon some specific direction regarding your desired outcome.  The key thing is that you feel that you've been heard.  One good test is to see if the surgeon reiterated to you at any point the key elements you mentioned: no dramatic change, no hollowed or suprised look.   You can always bring these points up again in a established consultation with the surgeon prior to surgery and see if you feel comfortable.   Another important aspect to consider when thinking about upper blepharoplasty is a discussion of your brow height and brow aesthetics.  That certainly influences the outcome of any upper blepharoplasty and is always part of my discussion with patients. 

James C. Marotta, MD
Long Island Facial Plastic Surgeon
4.9 out of 5 stars 126 reviews

How to avoid disappointing outcomes of cosmetic surgery

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Communication is the key to achieving success after any cosmetic procedure.  It is important to understand the goals of the procedure, reasonable expectations, risks, and recovery times.  If you have an idea of what you do or do not wish to look like afterwards, use old photographs of yourself to point out the features you wish to preserve.  Remember, your surgeon cannot read your mind.  However, if you feel that your surgeon is not hearing what you are saying you should seek opinions from other physicians.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

Talking to your surgeon

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It sounds like you are doing a good job talking to your surgeon.  If you have a frank discussion with them and possibly show them photos of eyelids you like, they will be able to tell you if you are a good candidate and if your expectations are reasonable. 


Good Luck.

How to avoid eyelid surprises

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It is important that you feel your surgeon is on the page as you regarding the result you want.  Most patients can demonstrate the desired result by pulling the brow or eyelid up or even better, bring in a picture of yourself from 20 to 30 years ago.  See pictures of patients that she has done.  You'll usually see a representative result.  If still unsure,  ask her to talk to a previous patient regarding their experience.  Good luck!

Joseph N. Togba, MD
Oakland Plastic Surgeon

Communicate to avoid blepharoplasty surprises

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The question you raised with us on this site, is an excellent place to begin your discussion with the surgeon about your blepharoplasty. We assume you have started with board certification, and a review of the practice web-site before your visit to the office. Bring photos to the discussion as well. Your surgeon should partner with you to get the result right.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Talk to your surgeon

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If you do not feel that your surgeon is listening to you, then find another. You need to feel that there is an open line of communication between you and your doc -- if you cant talk to them before, it will be worse after.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews


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You need to discuss your case directly with your surgeon of choice. If the answers do not feel right, go elsewhere. B very careful about your hooding issue. Lateral hooding is often an eyebrow problem and sholud be discussed before surgery

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Proper Communication with Your Plastic Surgeon

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Great Cosmetic results are not worth much if they are not the results you wanted and average to poor results are worse. The key to a happy Plastic Surgery patient is having the patient surgeon work as partners not with one dictating his/her idea of surgery to another who wishes a certain look he/she did not properly communicate to the surgeon.

When meeting your surgeon show him/her the results you want to achieve and the kind of results you would not be happy with. This will communicate to the surgeon what operation(s) should be done AND how realistic your expectations may be.

No ethical surgeon would be insulted by this type of interaction and most of it like it MUCH more than the passive "Do what you think, Doctor".

Good Luck.

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.