A blepharoplasty consultation, like those in other fields of medicine, consists of three main parts: an initial interview and medical history followed by a physical examination and then a discussion and recommendation.
The physical examination for possible cosmetic eyelid surgery does not require a multitude of technical tests by the doctor or the staff. Expect your vision to be measured and your eyelids to be photographed (although this is often not done until just prior to your operation). An experienced eyelid surgeon with a trained eye should be able to diagnose your problem with little more than thirty seconds of looking and tugging at your eyelids.
What you should want the most out of your consultation is a question and answer session. You definitely want to listen carefully as your surgeon explains your diagnosis, options, and any of his or her concerns, but don't settle for a canned lecture. The dialogue should go back and forth, give and take.
The following two circumstances should put you on guard:
If your doctor spends most of the consultation telling you how wonderful he or she is (or bad-mouthing the competitors) rather than discussing your needs, you may be dealing with an inflated or insecure ego.
If the doctor begins suggesting extensive and/or multiple procedures unrelated to or far beyond the purpose for which you scheduled your consultation, be aware that you may be dealing with a salesman. We are aware of one patient who walked out on a plastic surgeon during a blepharoplasty consultation after being told that he could help her much more with a breast augmentation.
Do not feel as if you need to direct the consultation. Your surgeon is a seasoned professional at what he or she does, while you are new to the process. Allow the consultation to develop naturally. If it seems to flow in an orderly manner, you can feel comfortable that your surgeon treats other patients with your problem on a regular basis. All of what your surgeon says should make sense, and if it doesn't, be sure to ask for clarification. If you doubt an answer or feel that the two of you are not communicating efficiently, don't be afraid to probe further or express your concerns. One useful trick is to ask your doctor to snap a Polaroid photo of your face and then talk from the photo.
There is nothing wrong with asking the doctor to go over his or her training and experience with respect to eyelid surgery. Being good at liposuction says absolutely nothing about a surgeon's competence with blepharoplasty.
If the doctor does not offer a web site replete with pictures of actual patients, ask to see before-and-after photos. While examining only one or two "all-time-best" results can lead to unrealistic expectations, demanding to scrutinize hundreds of photos is really just a waste of time. Be aware that you are being shown carefully selected patients with very satisfactory outcomes. If even those results appear mediocre to you, keep in mind that that is probably the best your surgeon can do.
Be sure the photos you are being shown are of the doctor's own patients and are unaltered. We are aware of a local ophthalmologist who was caught showing before-and-after photos copied from a classic textbook and representing the results as his own. And while you can trust the vast majority of cosmetic surgeons to be honest, there is always that small minority that will succumb to the pressure to impress by employing digital photo-manipulation.
In a perfect world, your surgeon would offer you a three hour consultation and thoughtfully address your every question and concern in painstaking, individualized detail. In the real world, doing so is neither practical nor possible, even for the most skilled and caring practitioner. So expect your consultation to last close to 45 minutes. If it's over in ten or fifteen minutes, you're getting cheated on even the bare essentials, something you may later come to regret. As the Welsh proverb goes, "Heaven defend me from a busy doctor."
Listen to your surgeon seriously when he's discussing potential limitations and complications. He may go over the downsides very fast, and if you don't pay attention now, don't complain later that you didn't understand.
How much should you expect to pay for a first-time cosmetic eyelid surgery evaluation? About $100-200. Much more than that is really not typical or reasonable. If, however, you are seeking revision surgery for previous bad surgery or have an especially complicated problem, expect higher fees.
Finally, remember that while one main purpose of the consultation is for you to interview and evaluate your potential surgeon, another is for the surgeon to evaluate your fitness as a potential surgical patient. If a doctor spots warning signs that suggest you may not be physically or psychologically well-suited for the operation or senses a personality conflict, it is his or her ethical obligation to decline to offer you care.