Most cosmetic surgeons offer either free or low cost individual consultations. Before scheduling, be certain that your appointment will be face-to-face with the doctor and not just one of the staff. In general, we have found that "free" fifteen minute appointments are not sufficiently comprehensive for either the patient or the doctor. The payment of a fee, even when small, shows that you are genuinely interested in considering treatment, and thus the doctor is likely to allocate more time to such an appointment and spend more energy listening seriously to your concerns, thinking about your diagnosis, and answering questions.
The examination for possible cosmetic eyelid surgery does not require a multitude of technical tests by the doctor or the staff. Expect to fill out a health history and be questioned about medicines, allergies, and so on. 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 want most out of your consultation is a sincere and in-depth give-and-take dialogue. You want your surgeon to listen to your questions and concerns, and then you want to listen as your surgeon explains your diagnosis, options, and any of his or her concerns.
The following two circumstances should alert you to put up your 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. Furthermore, 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 though 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 surgey. 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 photos, ask to see before-and-after pictures. 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 selected patients with satisfactory outcomes; if even those results appear mediocre, that's probably the best your surgeon can do.
Be sure the photos are of the doctor's own patients. We are aware of a local ophthalmologist who was showing prospective patients before-and-after photos copied from classic textbook and representing the results as his own.
A thorough consultation should last between forty-five and sixty minutes. Do not feel hurried. Likewise, listen to your surgeon seriously when he or she is discussing potential limitations and complications as they pertain to your particular case. If you don't pay attention now, don't complain later that you didn't understand.
Once your face-to-face meeting is over, the staff should present you with a detailed written fee proposal. Do not feel pressured to schedule your surgery on-the-spot unless you feel entirely comfortable with all that has transpired. Second opinions are common, although not a necessity. If you seek third, fourth, and fifth opinions, you may find yourself confused to the point of paralysis. Do your homework ahead of time (which is what you are doing now!) rather than wasting your time and money on multiple opinions from the wrong doctors.
By the way, in contrast to what you may read in some magazines, we do not believe that it is worthwhile speaking with prior patients. Not only is this an invasion of other patients' privacy, but you should expect to be presented with a list of contacts who, without doubt, will assure you that your potential surgeon walks on water.
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.
