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Cosmetic Blepharoplasty?

eyelid painting in gold frame

"Many would say an art dealer running a museum is a conflict of interest."
-- Jerry Saltz

Learning about blepharoplasty on the Internet is more difficult than many people imagine, especially when it comes to finding much beyond the same basic content. That's because "content" is not always the same thing as "information." The former is often more of a "filler" put there for different reasons while the latter denotes "education."

What's Available

Most big-name medical school and official Board mega-sites that dominate medical search engine listings for blepharoplasty surgery are watered-down to the point of near uselessness. Each reads like a clone of the others, one or two pages of over-simplified content extolling this or that treatment while glossing over serious discussion of blepharoplasty options, alternatives, controversy, or anything that might go against the sponsoring institutions. Lack of transparency? Of course, but why be surprised? The very purpose of their Internet existence is to promote their supporting member surgeons and encourage you to purchase their services.

But then is over-abundance necessarily better, like that found on sprawling social communities with thousands of seemingly random and frequently contradictory tweet-length reviews and opinions posted by nearly anyone with an email address? Don't confuse quantity with quality or marketing with education. If you weren't confused about blepharoplasty to start, you may be once you're done.

The same holds true for spending hours viewing before-and-after blepharoplasty photo galleries or videos of doctors performing cosmetic eyelid surgery. While it may at first feel interesting, unless you already understand what you're looking at and how to evaluate, you're learning next to nothing while wasting lots of time.

Then what about personal practitioner websites? Most are understandably skimpy on educational content beyond what you can already find everywhere, instead focusing on practical matters -- introducing the doctor, the practice, the office, the staff, and demonstrating before and after photos of their own blepharoplasty patients, all of which will become very useful once you've progressed from "merely interested" to "seriously ready."

And the television shows hosted by real doctors offering advice on the latest eyelid surgical treatment options? In a recent University of Alberta study, its authors concluded that "the research supporting these recommendations is frequently absent, contradictory, or of poor quality." In specifically considering the Dr. Oz Show and The Doctors, they found that between one-half and two-thirds of recommendations did not have believable evidence to support them.

What's left? It's unlikely there's much on blepharoplasty surgery at the public library, but you can always self-purchase a printed textbook written by surgeons, for surgeons.

medical journals

Most are excellent, although they're expensive, technical, packed with obscure jargon, and sometimes years out of date. Authoritative reference tomes are teaching tools intended for seasoned cosmetic surgeons already very familiar with blepharoplasty; it's unlikely you'll make it through the first chapter. Besides, doing one is not the same as having one, and some of the more practical topics pertaining to the patient experience are unlikely to be addressed.

So how about websites made for eyelid surgeons? Yes, there are several good ones, but their technical content is obscured in medicalese that make them almost unusable for anyone but a medical professional. Even more esoteric are the original five page medical journal articles that can be rented from the publisher and read like they're written in Swahili.

Face-to-Face Consultation

While you'll obviously need to meet with a cosmetic surgeon or two before making final decisions, don't expect too much from them as a source of broad ranging information. The average blepharoplasty consultation lasts about 20-40 minutes, but some are shorter. After hellos, an examination, a recommendation, and a discussion on costs, that leaves little time for in-depth education from even the most patient-friendly expert.

Is Personal Research "Overkill"?

Perhaps we should stop now and ask a more fundamental question. Does a potential patient interested in blepharoplasty even need to perform personal "research" before going under the knife? Isn't that unnecessary? After all, hasn't the medical establishment defined a "standard of care" set of guidelines for all eyelid surgeons to follow?

Taking part in major decision-making is not considered "overkill" by most prudent people; rather, it's quite the opposite. Who shops for a new car without first putting forth serious effort to determine what to buy and at what price and from whom? Who walks into a showroom and purchases the first model suggested?

Who bids on an alleged Old Master without first researching its provenance? Who but an inexperienced buyer confuses the glitter of an ornate golden frame for the true worth of its contents?

operating instructions

Okay. Where are these approved blepharoplasty "standard of care" guidelines published for the public to review and study?

Nowhere. It doesn't work that way. "Standard of care" is a legal concept that means little more than 'a prudent decision made by a competent doctor in the local community'. In actual practice, there are no formal manuals of eyelid surgery operating instructions, benchmarks, or best practices to which all surgeons must comply.

That's because most cosmetic eyelid conditions have a variety of possible approaches that could each be considered "prudent" in the right setting. Even the best blepharoplasty specialists can have widely differing opinions based on their own unique training, experience, and vested interests. For conditions like lower eyelid bagginess, for instance, recommendations from top practitioners can be all over the board.

this way

While that doesn't mean there is no best way to treat your specific eyelid surgery needs, it does mean that it may take more than an hour or two of effort to sort through the options.

So, can the FDA be of help? While the United States Food and Drug Administration does evaluate medications, medical devices, implants, prosthetics, and even nutritional supplements and some cosmetics, neither it nor any other federal agency reviews or approves new or existing operations for safety or effectiveness. When it comes to surgery, there exists a profound regulatory vacuum.

If this all sounds confusing, that's because it is. And if there is no obvious way to make sense of it, then why bother trying? That's why so many patients simply agree to whatever is recommended after their first twenty minute visit with a plastic surgeon.

Blepharoplasty For The Rest of Us

A blend between a course and a reference, Blepharoplasty 101 is intended not for surgeons but rather for the serious lay reader trying to decide whether and then how to undergo cosmetic eyelid surgery. It moves start to finish in a carefully organized way, distilling countless technical facts and data from a wide variety of sources into a form easily followed by the lay reader.

online library

Think of it as your go-to "companion" that can offer you practical but intelligent information on eyelid surgery whenever you need it -- before, during, or after -- neither superficially frivolous nor unbearably into minutia. And since information by itself is not the same as understanding, we supply plenty of candid insight, perspective, comparison, and even criticism, much of which you will find only here.

How It's Structured

Developed over a period of fifteen years, our exclusive content has been studied by millions of visitors (including many, if not most, oculoplastic surgeons) from around the world. Consisting of 45 main modules of articles, patient photos, diagrams, and videos, it covers every facet of blepharoplasty and is updated to reflect state-of-the-art.

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About the Author

BLEPHAROPLASTY 101 is the work of Dr. Frank Meronk, a graduate of The Johns Hopkins University School of Medicine and a fellowship-trained specialist in ophthalmic plastic and reconstructive surgery . . . More

If you're new to the subject, the resource starts at the beginning and progresses in an orderly fashion to the end. If you're already knowledgeable, you may instead prefer to hop around according to your interests.

The organization and progression are as follows:

We start off with a planning module (Topics 1-12). In these chapters, we'll show you to better understand the group of procedures that make up modern "blepharoplasty" to be presented in more detail later on. We'll describe pertinent facial and eyelid anatomy and physiology (don't worry -- it's not as dry as it sounds) and explain common eyelid signs and symptoms that lead people to seek out eyelid surgery. We'll then discuss general treatment issues, such as your choice of operating room facility and the different types of available anesthesia and lots on the costs. We'll also offer a great deal of guidance on how to get the most out of your consultation and how to identify, evaluate, and select an eyelid specialist.

Next, we delve into the specifics of blepharoplasty and a number of related operations and adjuncts (Topics 13-27). We'll present their treatment variations and discuss how each is performed, the results you can reasonably expect, and plenty about each procedure's pros, cons, and alternatives, including lots of illustrations and actual surgery photos. We'll tell you about which eyelid operations are established, new, antiquated, still developmental, or best approached with caution.

Next up comes a detailed look at the risks you face by electing to undergo blepharoplasty surgery and then an overview of the most effective revision techniques to address any complications should they arise (Topics 28-30).

We'll tell you about what most people need to do (and not do) to prepare for a typical blepharoplasty, after which we'll walk you through the experience from the perspective of a patient and again explain what you need to do (and not do) to recover and heal (Topics 31-41). While none of these suggestions should take preference over your own cosmetic surgeon's instructions, you'll find a great deal of good information here and may even discover some useful tricks.

Plus, there's more, such as six additional self-contained modules on Before and After Photos, Eyelid Hollowness, Functional Eyelid Surgery, Asian Eyelid Surgery as well as a helpful Glossary and an Atlas of Eyelid and Orbital Anatomy. Included is a sneak-peek of Blepharoplasty 2.0, eye plastic surgery of the future.

Please understand that this resource is not intended to replace or contradict any advice from your own cosmetic surgeon, who, in the end, will examine you and then offer an appraisal of your personalized needs. Use it to learn about the subject and to help formulate your questions, but act only on your own doctor's recommendations. He or she is the one treating you, not us.

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Ready, Set, Go

That's it for the introduction. Now, prop open those baggy eyelids and brew yourself a cup of coffee.

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It's time to get started . . .

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Frank Meronk, Jr., M.D.
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Disclaimer: Information, observations, and opinions are presented for general reference use only and do not constitute specific medical advice, diagnosis, or treatment. Base all decisions solely upon the recommendations of your own doctors. With each use of this website, you signify your review and full acceptance of our most current Terms of Use, Copyright Infringement Policy, and Online Privacy Policy.

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