Following is a list of items you should pay at least some attention to while searching for a competent eyelid surgeon. Except for the first three, they are not listed in any particular order of importance but more in the sequence in which you are most likely to encounter them during your search.
Remember this above all else: The three most important criteria for selecting a blepharoplasty surgeon are: 1. Experience, 2. Experience, and 3. Experience. If a surgeon performs cosmetic eyelid surgery a few times a month in between tummy tucks, that is not experience. If a surgeon performs blepharoplasty three, four, or ten times a week, week in and week out, that is experience.
Now, on to some of the secondary factors.
Reputation: Clearly, this is a big one because it takes years of hard work to earn and maintain. If a surgeon has a sterling reputation for good results with eyelid surgery among other doctors, nurses, former patients, and your beautician who studies face after face, he or she most definitely gets a giant gold star next to his or her name.
Commercial directories: If you've stumbled across directories of doctors' names entitled something like "Best Plastic Surgeons in the Universe," understand that most such publications are basically schemes by marketing companies to generate income for themselves and their participants. Despite official-sounding titles, the selection process used in most is very limited. Some of the doctors listed may be excellent, while others are simply willing to "buy" their way in. It's like on the web. There are a zillion web directories entitled something like "Best Plastic Surgeons--Find Them Here for Only $29!" Would you fall for this? Probably not. So why think a printed version is fundamentally any different?
Online message boards: Whatever you read -- good or bad -- should be taken with a BIG grain of salt if not totally discounted. While originally well-meaning, some message boards have allowed themselves to turn into toxic "free-for-alls" where anonymous users feel emboldened to "talk up" or "talk down" their (sometimes imaginary) experiences, commit blatant libel against an excellent doctor, or put forth a free advertisement for the doctor they work for. While you may sometmes find a nugget of good advice, most boards are parts of bigger sites designed to sell you products and so actually encourage rumor, gossip, and controversy to attract potential customers.
Location: Is a surgeon from, say, Beverly Hills necessarily better than a surgeon from, say, Fresno? Real estate agents marketing office space in high-rent districts are concerned only about the financial solvency of a potential client and not at all with surgical outcomes. Any doctor can maintain (or share with ten others) a luxury office on Park Avenue. The only thing you can be absolutely sure about when visiting a surgeon at an exclusive address is that his business overhead is very much higher than that of his peers and that you are the one who is going to pay for it.
Self-promotion: Use of commercial advertising media has recently become the norm in cosmetic surgery, while more subtle forms of self-promotion such as the yellow pages and office brochures have been around forever. As long as advertising is undertaken in an ethical fashion, there is nothing wrong with it. Beware, however, of doctors who make grandiose claims about being "world renowned," who exaggerate about "teaching other doctors," or who refer to their skills using constant superlatives. Ads to promote name recognition and availability are standard business practice, while ads intended to deceive or talk you into something are not. Distinguishing the two is not always easy.
University affiliation: 'Assistant Clinical Professor' does sound nice, but what does it signify? In many cases, less than you probably think. Most serious academic appointments come without the word 'clinical' (for example, 'associate professor') and typically indicate a full or near full-time appointment on a university staff. 'Clinical' appointments, on the other hand, are often handed out to private practitioners willing to help volunteer by teaching a beginning resident how to put on sterile gloves (not something a busy academic has time for) or give an occasional short lecture in return for the accolade. Sometimes, the involvement might entail as little as a few hours a year at an affiliated county hospital located a hundred miles away from the main program. While a major university medical school may have one or two active oculoplastic surgeons on full-time staff, there may be ten times (or more) that many 'clinical' appointments.
Yellow pages: There is an old saying that goes something like this: "The surgeon who specializes in everything specializes in nothing." If a doctor lists himself in the phone book as devoting his practice to eyelid surgery, such a clear emphasis gets a big star. If a doctor claims to specialize in twenty-two cosmetic surgery procedures involving the face, breasts, and buttocks, then no star for him or her. While this doesn't, of course, prove that he or she isn't a fine eyelid surgeon, it does show that eyelid surgery is not emphasized in the practice (see What is a True Eyelid Specialist?). Simply because a doctor is a plastic surgeon does not mean that he or she specializes in cosmetic eyelid surgery or can do the operation well. Plastic surgery on most other parts to the body - from scalp to breast to thighs - bears no relationship to blepharoplasty.
First phone call: First impressions are important. If you call an office to ask about eyelid surgery and the receptionist acts lost, a red flag should go up.
The waiting room: The waiting room (and entire office) should be clean, well-maintained, and tastefully decorated. It does not need to look like the lobby of a world-class hotel or museum, but then again it should not look like an airport lounge or a gaudy tasteless circus. If the office is dirty and looks unloved, think twice about where you are.
The staff: The staff should be well-groomed, polite, friendly, and knowledgeable. Plastic surgeons can afford to hire better-than-average employees. Remember that you are a potential customer seeking premium services at a high price. If you find yourself being treated as if your HMO reluctantly approved a ten minute visit to check out your chronic cough, be wary.
The doctor's credentials: Pay attention to where your doctor received his or her training, but don't stress over it or let yourself be too easily overwhelmed. While lots of certificates on the wall may look reassuring, they may say little more than the artwork does about a surgeon's current skills (plus many of the most "impressive" certificates can be bought by simply paying annual dues). Just because your surgeon is smart, by the way, doesn't mean he's dexterous or has a refined sense of taste. Just because he graduated from Harvard Medical School thirty years ago doesn't mean he's kept up to date. Board-Certification in an appropriate specialty (Plastic Surgery, Ophthalmology, Dermatology, ENT) should be expected, but be aware that even this says little about a surgeon's current level of competence. To learn more, see The "Myth" of Board-Certification.
The doctor: Finally! While the specifics of what to expect during the actual consultation are covered in the next chapter, let's concentrate more on the person who may be cutting on your eyelids very soon. He or she should be well-groomed and neatly dressed. Three-piece designer suits are for show only; being a cosmetic surgeon is a hands-on job and at times messy or even bloody. A white lab coat is truly the most appropriate garb.
Look for personal traits that you would admire in any person with whom you intend to do serious business: intelligence, a smile, a willingness to listen, an ability to express thoughts and concepts, thoroughness in any actions or answers to questions, a lack of aggressive salesmanship, and so on. Is this somebody who you think you can trust? Is this somebody who seems smitten with himself? Are you being treated with respect or in a condescending manner? Do you feel comfortable with this person or do you already sense a clash of personalities? All such Gestalt matters now (and may matter much more after surgery). Ask yourself: Do you feel confident placing your face at this person's mercy (which is, after all, exactly what you will be doing)?
Remember that you have not been "assigned" to this doctor by some uncaring insurance company. If you feel the least bit uncomfortable, try out another surgeon. While the good ones don't exactly grow on trees, there is always more than a single choice.
We all know how difficult it is to make reliable judgments about a person's true nature and integrity based upon a single meeting. Unfortunately, that's how it goes. You may be interested to know that it isn't all that easy for any given doctor to size up another doctor, especially if he or she comes from another specialty.
So, pay attention to the hints discussed above and consider the advice found elsewhere in this Guide. At least you can feel confident that you've given the process your best shot and met your responsibility to your eyelids.
Related Article:
How to Judge Whether a Doctor Does Much Eyelid Surgery with One Phone Call
