Nightmare Browlift, Lower Blepharoplasty, and Cheek Implants - Philippines

This is a letter I wrote to my surgeon in the Philippines who did my lower bleparoplasties. I have deleted some parts and replaced them with ***:
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Doctor ***:

It has now been one year since I visited you for browlift, lower blepharoplasty, and cheek implants.

I want to let you know what has happened to me since.

My browlift was done fine. My cheek implants were OK, with some imperfections where I could see the outlines in strong light, though I was not too worried about that.

My lower blepharoplasties were a disaster.

After returning back to ***, the swelling subsided and to my horror, revealed severe ‘round eye’ with noticeable scleral show. After thoroughly researching my problem during the past year, I have learned a lot. I completely regret ever having lower blepheroplasty done.

I learned that my particular facial anatomy was a huge red light for doing lower blepheroplasty with skin excision. As I understand it, the critical factor was my poorly-developed sunken orbital bones. As a patient, I trusted you to be aware of this factor, which, I have come to know, is basic knowledge among plastic surgeons. I was completely the wrong candidate for this kind of surgery.

The effects have been devastating. Having round eye / scleral show gives a person a ‘dopey’, sad, and unattractive look, and is key evidence of botched lower blepharoplasty. This socially-disabling problem has crippled my self-confidence.

I’ve also learned about how difficult this is to fix. In July, I visited Dr *** in Boston for revision surgery after scouring the internet for solutions. Dr *** is famous for fixing botched facial plastic surgery. He removed the cheek implants and placed medial orbital implants, and he did lateral canthopexies and a mid-face lift. All of these procedures were intended to boost my deficient malar + lower-eyelid region. The cost for the surgery alone was US$15,000.

Dr *** improved my round eye / scleral show very slightly, but I still had major problems. My lateral eyelids still drooped down awkwardly, and I continued to have a very unnatural and uncomfortable feeling of the eyelids ‘pulling-down’. Afterwards, I emailed him about my discomfort, and he said there was nothing else he could do; because my original surgeon (you) took away too much skin and fat, which is basically irreparable.

Since then, I’ve had lateral orbital implants placed by another surgeon, because I figured that would help lift the lateral lower eyelids up. It hasn’t really helped at all. My lower eyelids are still sunken and collapsed-looking.

This has all been a nightmare. I stay positive by clinging to hope that this can be fixed one day. Possibly the last option is a rare surgical procedure, done by an oculoplastic surgeon, involving hard palate grafts (known as the Madame Butterfly procedure) in order to give the eyelids some rigidity and lifting. There is also something called the tarsal strip procedure, which may also be an option. The prospect of more surgery is overwhelming, but one I have to face. I hope and pray that I can resume a normal life before I turn 30. I don’t need to look perfect, but I certainly want to look more natural than I do now.

I hope you can learn from my experiences in order to avoid the same mistakes on other patients in the future. I never dreamed that a common surgery like lower blepheroplasty could have such devastating effects on a person’s life. Please, for the sake of others, do some more study on the suitability of candidates for lower blepharoplasty. Perhaps Philippino people do not often have the kinds of facial characteristics that render them vulnerable to lower blepharoplasty complications, but because you see a lot of foreign patients, you need to be aware of these risks.

I’m not sure how you will respond to this email, or if you will respond at all. I realize that it must be a hard job being a plastic surgeon. I’ve been meaning to write this letter for quite some time.

Regards,

***.