My eyes are no longer the same

Dr. Vrcek responded to my google review and since they don't allow a response there, I'll post it here.

*Regarding his response to his statement that I showed him a photo of my desired results then changed my mind after surgery: I did not share a photo before surgery to show my desired outcome. Dr. Vrcek claims, in our email exchanges, that he recalls me either holding up a corner of my brow or showing him a photo during the virtual consultation, neither of which occurred. Why can't he reference my patient notes from the consultation and state exactly what occurred versus seeming to recall two different scenarios. We had discussed my desire for a natural, conservative result, which I ultimately did not receive. He claims I changed the plan after surgery which is not the case in any way. He is the one who did not follow the plan for the result we discussed, then added procedures I did not need or request to be done.

*Post-surgery communication: While we did communicate my concerns for a few months after the surgery, upon discovering he performed procedures I did not request or need, and his continual disregard for these concerns, my husband and I lost trust. This prompted us to stop further communication and seek follow-up care from a local oculoplastic specialist.

*Travel coordination: Dr. Vrcek, nor his staff, never mentioned the possibility of coordinating travel plans to meet the day before surgery. In hindsight, I wish we had thought to do so as, if he had examined me properly, he would have realized his assessment based on emailed photos for the virtual consultation was incorrect.

Everything stated in my original review is fact based, and I have been nothing but honest and open in every one of my Facebook post updates.

*Ectropion repair and festoon elevation: At no point did Dr. Vrcek mention these procedures as part of my treatment plan. Why would I have been surprised to find these were done without my knowledge if I had specifically requested or expected them? As shown in my before photos, I did not have large festoons under my eyes, nor sagging eyelids, much less to the point that would require extensive repair, as was billed to insurance.

*Nerve damage from the brow lift: The endoscopic brow lift resulted in nerve damage, leading to supraorbital neuralgia. I have undergone ketamine infusions, which provided only minimal and short-term relief. I am now scheduled for a nerve block. My neurologist has indicated that, at the one-year mark, this condition is more than likely permanent.

*Dry eye and blepharitis: The dry eye and blepharitis require the use of eye drops throughout the day, gel drops, and a mask at night, along with ongoing care from a dry eye specialist. The specialist has recommended IPL (Intense Pulsed Light) therapy as a potential next treatment. My tear evaporation rate is under two seconds which is miserable.

It's been almost a year since I underwent upper and lower eyelid surgery, ptosis repair, fat repositioning, chemical peel, and additional procedures, all performed by Dr. Vrcek. I apologize in advance for the length of this post, but I feel it's important to share my journey with others who may be considering similar surgery.

First, my husband and I absolutely agree that Dr. Vrcek is kind and very accessible both prior to and after surgery. While I believe he tries to have his patient's best interest in mind, he failed me. 

Upon reviewing my insurance claims, my husband and I were shocked to discover that Dr. Vrcek performed a senile ectropion repair, which we were never informed about beforehand. I had no idea he intended to do this procedure, and it wasn’t until after the fact that we learned it had been included. I had never suffered with hanging lower eyelids or any issues that would necessitate such repairs.
While I did inquire about my eye shape during a follow-up email (as another person had mentioned was a good question to ask), I was told that no changes would be made to my eye shape. Dr. Vrcek assured me that he wasn’t doing anything to alter it. However, when I followed up about the ectropion repair, he explained that tightening the lower tendon during ptosis repair is a procedure he often performs. Yet, when I consulted with another oculoplastic surgeon later, I was told that ectropion repair is not a part of ptosis surgery. In fact, this second surgeon, who had examined me a few months before my consultation with Dr. Vrcek, noted that I had shownabsolutely no signs of ptosis at all.

In addition to the ectropion repair, Dr. Vrcek also performed festoon elevation—another procedure I was unaware of. We had a very brief consultation about minor malar bags during my second virtual consultation, which I mentioned could be addressed with my upcoming facelift and neck lift in a few months if the surgeon felt the need. I certainly did not expect or end up requesting any treatment for festoons, so discovering it was done without my consent was deeply upsetting. I even asked Dr. Vrcek, after reading the surgical notes, if the fat repositioning done was the same as festoon elevation, and he clarified that the two are entirely separate procedures.

As recovery continued, I struggled with the emotional and physical effects of the surgery. As the swelling began to subside, I sent Dr. Vrcek photos showing how the natural hooding I had on my upper eyelids my entire life was now gone. I noticed significant changes in the amount of skin and fat removed, which was far more than I had expected. When I initially consulted with him, I was quoted $2,000 for upper eyelid surgery, with the understanding that it would be a simple skin removal procedure. I was led to believe it would be a conservative approach, not a dramatic alteration of my natural anatomy. He initially stated that insurance would NOT cover both skin removal and ptosis repair, and that we would save a significant amount of money by having the ptosis repair covered. However, in a later email, he revised his statement, saying that insurance MAY not cover both procedures
In response to the photos I sent, Dr. Vrcek replied, “If a patient were to show me a picture of themselves in their 20s, but they’re in their 40s or later, I would tell them it’s not possible for me to make it look like they did in their 20s.” However, I didn’t expect to look like my younger self. I simply wanted to look like me but refreshed. Instead, my eyes are no longer the same—they no longer resemble the eyes that gave me my identity.

I also want to clarify that I didn’t expect perfection. I understand that no surgeon can promise that. But what I did expect was to still look like myself, with the integrity of my natural features intact.
Dr. Vrcek also mentioned that it’s challenging for surgeons when patients send photos from their younger years that benefit from ideal lighting, makeup, and sometimes even filters, and then compare them to photos taken during the healing process, which are often less flattering due to lighting and swelling. He said, "I don’t think any surgeon could successfully pass this test."

The photos I sent, spanning from my younger days to last year, were not intended to compare idealized images of my youth to my current post-surgery appearance. They were simply meant to show how much he had changed my eyelids. I have plenty of photos—without makeup, in various lighting, and at different times of day—leading up to the surgery, some of which I’ve shared here. The fact remains: I had a natural hooding and a small lid platform before the surgery, and now I no longer do.

The redness around my eyes, which my eye doctors attribute to ongoing inflammation and meibomian gland issues, has not gone away. Some days are worse than others, and the pain in and around my eyes remains a constant challenge. I am also experiencing trigeminal neuralgia affecting my supraorbital nerve, causing sharp, radiating pain from my scalp down across my eyebrow and upper cheek. In addition, I’m dealing with dry eyes, persistent tightness in my forehead, and discomfort that intensifies when I try to move my eyebrows or look up.

I’ve been doing everything I can to manage these issues: using eye drops and nasal spray, wearing climate control glasses, applying gel drops, running a humidifier at night, and exploring pain relief options like ketamine therapy and acupuncture. We also have an appointment with the Johns Hopkins Wilmer Eye Center next month in the hope they can figure out and treat the ongoing pain, tightness, and pressure I feel in my eyes.

What’s been especially difficult is realizing I was never fully informed about the extent of the procedures to be performed. Dr. Vrcek didn’t examine me in person before surgery, despite the “in-person” documents submitted to insurance stating otherwise. On the morning of my surgery, I was very nervous and made a grave mistake. I was asked by the nurse checking me in to confirm the procedures I was having, and I stated them as they were presented to me as shown in my Facebook posts and prior communications. However, when I reviewed the paperwork later, I saw that bilateral ectropion repair and bilateral festoon elevation had been added in, while fat repositioning and the chemical peel were omitted.

The additional surgeries and unexpected changes have made it hard to accept, as they were not part of the plan I agreed to. My husband and I were told while I was in recovery that I would look “great” by Christmas, and ready for my facelift and neck lift surgery in February. Yet, here I am, a year later, still struggling with physical pain and emotional distress over the outcome.

I want to make it clear that this isn’t meant to discourage anyone from pursuing surgery. There are patients who are happy with Dr. Vrcek’s work, but my experience has been very different. My advice to anyone considering surgery is to get multiple consultations and always request an in-person meeting with your surgeon before proceeding. Virtual consultations are helpful, but nothing replaces a hands-on examination where the surgeon can truly assess your needs through exams and required testing and explain the surgical plan in detail. If a surgeon doesn’t take the time to discuss the procedure thoroughly with you, including risks and potential complications, I would strongly consider looking elsewhere. Informed consent is critical: you need to know exactly what the surgeon plans to do, and what could go wrong.

I made the mistake of trusting Dr. Vrcek without fully understanding and knowing the scope of the procedures he planned to perform. The changes to my appearance have been far more dramatic than I anticipated, and I feel that my identity has been altered in ways I never intended. I also want to emphasize that I never expected perfection. I simply wanted to look like myself, only refreshed. Unfortunately, I no longer recognize the reflection in the mirror.

Dr. Vrcek’s response to my concerns included an explanation of how he often tightens the tendon during ptosis surgery as a preventative measure to avoid lower eyelid retraction, but this was not something I ever discussed with him. I only asked if the surgery could change my eye shape, and I was assured that it wouldn’t. Yet, senile ectropion repair using tarsal strip was performed without my consent, despite my having no symptoms of this condition prior to surgery. We believe that this unnecessary procedure plays a huge part in the tightness and pain I have in my lower eyelids.

The whole experience has been emotionally challenging, especially as we discovered, post-surgery, more about what was done. In hindsight, I wish I had done more research and asked more questions. Better, would be that the surgeon, the subject matter expert, take the time to have these important conversations with his patients, ensuring he is familiar with their goals and ensure they understand what his plan is to try to meet those goals. Surgery is a significant decision, and once it’s done, there’s no going back.

If you’re considering similar surgery, I encourage you to read my posts and think carefully about the questions you ask your surgeon. Do your research, seek multiple consultations, and always ensure you’re fully informed before making any decisions.

This post is not meant to scare anyone away from having surgery, but rather to share my personal experience as a cautionary tale. Please remember that everyone’s results are different, and my story is not reflective of every patient’s experience with Dr. Vrcek. But if you’re considering surgery, my best advice is to make sure you’re well-prepared and that you’re working with a surgeon who is transparent, communicative, and truly listens to your concerns.