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Topic 6 - 3
What is a True
Ophthalmic Plastic Surgeon?
best eyelid surgeons Surgeons eyelid surgery board certification

specializing on eyelids

"Specialists learn more and more about less and less until, finally, they know everything about very little. Generalists learn less and less about more and more until, finally, they know nothing about almost everything."

-- Adapted from Donsen

Many years ago, a "surgeon" was a specialist physician who performed operations on every part of the body. However, as surgical technique grew more complicated and standards for excellence and safety more demanding, it became clear that a "specialist" who specializes in everything specializes in nothing.

What emerged out of necessity was the rich selection of surgical specialties we enjoy today, including neurosurgery, cardiovascular surgery, orthopedic surgery, and so on, in which a true expert surgeon can focus his practice around what he or she does the best.

More recently, the field of plastic surgery has undergone a similar evolution as it has grown more difficult for any one practitioner to acquire the knowledge, skills, and experience needed to operate effectively on multiple parts of the body.

The "one-stop, full-service surgi-lift clinic" is becoming a relic.

Q: When it comes to surgery on the eyelids, aren't most cosmetic surgeons more or less the same?

A: According to American Society of Aesthetic Plastic Surgery statistics for 2013, more than 26,500 physicians were likely to perform cosmetic plastic and reconstructive surgery procedures. In 2013, there were 161,000 blepharoplasty operations performed.

Thus, the average "cosmetic surgeon" performed just six such surgeries during the entire year.

An ophthalmic plastic surgeon (also known as an oculoplastic surgeon) is a physician with advanced training in treating disorders of the eye, eyelids, lacrimal system, and orbit. An eyelid specialist is a physician who has carried such specialization one step further and devotes his or her practice to eyelid surgery alone.

Why There Are So Few

After medical school, a budding oculoplastic surgeon undertakes a three year residency in ophthalmology, after which time one or two additional years are spent in fellowship-level training in ophthalmic plastic and reconstructive surgery.

Skills are gained in the diagnosis and treatment of conditions involving the eyelids, tear system, and orbit at one of a very limited number of University programs. Such directed study is far more comprehensive than that obtained during a general plastic surgery residency in which training time must be divided between all the parts of the body and only weeks (rather than years) can be devoted to the eyelids.

practice makes perfect

There are less than 500 surgeons in the United States who have completed such advanced training. While some then devote their practices to oculoplastic surgery of the lid, orbit, and tear system, only a few go so far as to limit their surgery to the eyelid alone.

Why? With growth of the "managed care" industry that places minimal premium on such focused specialization, many well-trained oculoplastic surgeons have found it necessary to broaden their practice horizons.

Thus, some former eyelid surgeon specialists have "de-specialized" by incorporating (or even emphasizing) general ophthalmology (such as cataract and LASIK surgery) or introducing cosmetic operations not directly related to the eyes (such as face lift, neck lift, and liposuction) into their practices.

In fact, the number of surgeons who devote their full practices to eyelid surgery is small and to cosmetic eyelid surgery alone much smaller.


When assessing a potential surgeon's qualifications, bear in mind that the delicate eyelid tissue is not merely a facial adornment.

As central as the eyelids are to
facial appearance, their more
important role is to protect and
nurture a very delicate organ


that most non-ophthalmologists
know very little about.

Because of an eyelid specialist's advanced training and experience in both ophthalmology and cosmetic and corrective eyelid surgery, he or she is especially well qualified to assess the impact of the eyelid on the health of the eye itself. Many patients feel more comfortable knowing that their eyelid surgeon possesses such expertise.

Any licensed physician, however, may choose to perform eyelid surgery. While most general plastic surgeons and some general ophthalmologists provide certain types of eyelid surgery, blepharoplasty is sometimes also offered by family practitioners, obstetricians, and even dentists "specializing" in cosmetic surgery.

doctor awards

Q: What about cosmetic surgeons rated gold, silver, platinum, copper, tin, and top eyelid surgeons of the year by big cosmetic surgery websites?

A: Most such "accolades" are awarded by various super-sites based primarily on doctor availability and participation on the site (and sometimes also by anonymous user comments), not by verified knowledge or audited experience or objective evaluation of their patients' results. While the badges and medallions do look impressive in advertisements, they signify little about a practitioner's skill with blepharoplasty. We can't think of even a single official medical organization (national associations, medical Boards, licensing boards, etc.) that ranks its members by quality.

Next: Eyelid Surgery and
the Myth of "Board Certification"

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Frank Meronk, Jr., M.D.
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