I came across this video segment from ABC news about men and facial plastic surgery. Botox use and eyelid surgeries among men are becoming increasingly popular. I’ve seen and operated on quite a few men the past few months, many of whom were told by their wives that it was time to address their drooping eyelids. Check out the video below.
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January 29, 2012 by Dr. Matheson Harris
Bro-tox: More men getting facial plastic surgery and using Botox
Tags: aging, botox, bro-tox, eyelid surgery, facial surgery, men
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January 24, 2012 by Dr. Matheson Harris
10 things you must know before having cosmetic plastic surgery
Making the decision to have a cosmetic procedure is a big one, and one you shouldn’t take lightly. When weighing their options, many people get too focused on one particular aspect, such as cost or reputation of the surgeon, while overlooking other important details. The following can serve as a checklist to consider before making the decision to commit to a procedure and surgeon.
- First and foremost, find a surgeon you are confident will do the right thing for you. Selecting a good doctor is a process in itself that I covered a few weeks ago on this blog. To summarize the highlights, you need to seek out a person with quality experience, board certification and fellowship training, which ensures their colleagues have seen their work and have given the stamp of approval. It is easy to pay for a weekend course in a procedure and set up shop doing it, but there is little to no oversight in the learning process and the surgeon’s skills are an unknown. You will also hopefully like this doctor and feel they treat you with respect. If they are marginal in their manners before you have surgery, their manners are unlikely to improve once they have been paid.
- Ask the surgeon to explain all your options, including those that don’t require surgery. There is rarely only one way to do things and often the best treatment is no treatment at all. Be wary of someone who has a cookie-cutter approach to all patients, steering them into the procedure he/she is most comfortable with or is most lucrative. My patients are always surprised when I end up telling them I wouldn’t have surgery in their case. They seem at first shocked, then appreciative that I would direct them away from something that I’m in the business of doing. For a careful surgeon, however, it is a no-brainer. Surgery is complex and creates myriad problems that must be overcome before a good outcome can result. Doing a procedure when it isn’t indicated or in the patient’s best interest is just a recipe for regret for all parties concerned.
- Don’t choose based on cost. Choose based on outcomes. A surgeon who is significantly cheaper than everyone else has often lowered his/her prices to attract clients that word-of-mouth referrals aren’t generating. In tough economic times you will find lower prices, but don’t let this mesmerize you into overlooking other potential negatives of the doctor or facility.
- Know the risks. Every surgery, no matter how simple or how great it turned out for your best friend, has risks of complications. For example, I perform ptosis eyelid surgery, which is notoriously unpredictable. Correcting ptosis, or a drooping eyelid, involves isolating delicate muscles and adjusting them to move the eyelid to an exact level, symmetric with the other side. During surgery we make careful measurements and even have the patient open and close their eyes to ensure symmetry. However, it is not uncommon to have everything look perfect in the post-op area, then a week later after swelling and scarring have taken their toll, have the eyelid be slightly off. A difference of only 1 millimeter is often unacceptable to patients and may need a revision. Most good surgeons will spell this out to the patient before surgery, but almost no patient seems to remember this when it actually happens to them. When you go in knowing there can be complications and directly ask about them, you are less likely to be surprised when things don’t go exactly as planned.
- Understand anesthesia and its limitations. Many cosmetic procedures are performed under sedation, not general anesthesia. This means the patient is awake, but given medicine for relaxation and pain by IV infusion. Depending on the procedure, this anesthesia can leave the patient completely aware of what is going on during surgery. Most people will see that avoiding general anesthesia is a plus as you recover much quicker immediately post-op, can leave the surgery center after as little as 30 minutes, have no sore throat from a breathing tube, and are less likely to have nausea from anesthetic gas. For others, the thought of being aware of surgery is too much and will result in anxiety. Talk to your surgeon about exactly what your level of awareness will be and if you are comfortable.
- Inquire about the site for your operation. Will it be in a hospital, an outpatient surgical center, in the doctor’s minor procedure room, or in a reclined exam chair. Different procedures require different support and certain more involved surgeries need to be done where help exists if something goes wrong. If a surgeon insists on doing a procedure in their office, ask if you could have it done in a surgery center if you chose. If the answer is no, there may be an issue with the doctor not having credentials to perform surgery in an accredited surgical center. This is commonly a problem with physicians operating outside of their formal training. If a family practice physician decides to start doing liposuction by getting trained at a weekend course, they will likely not be able to convince a reputable hospital of surgery center that they are proficient enough to perform the procedure. They will have to perform the lipo in a medi-spa or outpatient office where they alone would be liable in the event of a complication. A doctor maintaining privileges at one or many hospitals is a sign that he/she has been cleared by both peers and insurance adjusters to perform quality surgery.
- Avoid surgeons who claim to be the only one doing a procedure. This is a tough one. We all want the latest and greatest technique, but if only one person is doing something, it may not yet be tested for general consumption, or it may be just different to entice early adopters. You want proven surgical techniques that are accepted by the majority of surgeons because of their good outcomes. Look at the history of facelift techniques and you’ll see lots of procedures that have come and gone, trying to simplify the procedure and lessen complications, but many of them gave poor outcomes and were abandoned. Find someone doing a tried and true technique with long-term patient follow-up results.
- Ask about recovery time. This varies widely from patient to patient and procedure to procedure. The majority of facial cosmetic procedures will leave you looking like you’ve been in a fight for a week or two, sometimes more. As with complications, patient rarely seem to remember the conversations we have before surgery about how bad they will swell and bruise, and they tend to be shocked the next day by their appearance. Knowing that you will look pretty rough for a few weeks, and that it will get better, will help your patience to wait out the outcome you are expecting.
- Ask about long-term outcomes. Gravity and aging are constantly working against our desire to look young and vigorous. A great surgical result today doesn’t tell you anything about what you’ll look like in 1, 5 or 10 years. Ask your surgeon how long they expect the results to last, and then remember, they don’t have a crystal ball and everyone ages at different rates. As cosmetic surgery is expensive, consider having a procedure done once the improvement will be more noticeable and less likely to need repeating. This will also prevent that buyer’s remorse commonly seen when people find the surgery didn’t make the life altering change they were expecting.
- Manage your expectations. We all want to look like we did in our youth, but there are limits to the effectiveness of surgery. As I’ve said before, the hardest part of my job is helping people understand before surgery what they can expect after surgery. Remember the older you are, the more wrinkles present, the more advanced your problem, the more difficult it will be to restore the past look. The patients I find are most pleased after surgery are those who say things like “I don’t want to look 18 again, I just don’t want to look tired all the time.” These are reasonable expectations from cosmetic surgery. Patients that focus on every crease and fold as if those are the key to why they don’t look like a teenager anymore are in for a potentially disappointing and expensive experience chasing youth.
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Tags: cosmetic surgery, facial plastic surgery, finding a good doctor, surgery complications, surgical risks
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January 11, 2012 by Dr. Matheson Harris
Best Face Forward Contest Finalists
We have been running a contest for a free eyelid lift and are down to our 10 finalists. Unfortunately, the contest app only shows the contestants pictures, but not the stories they sent along with them. We felt they were so compelling that we wanted to share them for anyone interested in voting. After reading, you can go to our Facebook fan page, “like” us and vote. Here they are in random order. Voting ends January 19th.
Marian Jones
The eyelift is for my mom Marian who lives in Utah. She’s wanted an eyelift for about 10 years now as it’s been hindering her sight. She couldn’t afford it due to costs from breast cancer and other health concerns. After two mastectomies, she is now cancer free and has lost 50 lbs this past year! This would be the perfect Christmas gift for her to boost her self-esteem, restore her vision, and celebrate her and her accomplishments these past 5 years.
Sherry Weston
I need an eyelid lift because I am only 41 and my eyelids are way too droopy! (along with some other things). I am a newly divorced mother of 3 beautiful little girls all under the age of 10, I came out of a abusive 10 year marriage. I have overcame many obstacles in my life. And I have been through allot in my life and it really shows…All over my face.
Pat Rusk
I was an elementary school teacher for 33 years and it was a job that kept me young at heart – if not in face. Now I work as an advocate for teachers. As a working professional, it would be nice to be able to wear eye makeup that others could actually see. It would be nice to have visible eyelashes. I would love to stop hiding behind glasses, wear contacts, and maybe even hear comments about my big brown eyes again.
Jeff Wells
My family genetically has had fat eyelids. I have not mined it until recently when, on most days I can actually see the eyelid when I look normally at my surroundings in the distance. I feel self conscience about it. My regards, Jeff
Emilee Fike
When I was in fourth grade I injured my left eyelid by being bullied. I was pushed by a boy while on the monkey bars:( The result was me falling and anding face first on a rail road tie. I have a large scar and the eye socket was broken. The eye socket is not noticeable except by touch and photos show a uneven look. My parents never were able to repair this injury. We were the typical large Mormon family, and my dad was the sole provider. My oldest brother battles with schizophrenia and and younger sister with a paralized arm was the focus of any medical treatments for my parents. I now am happily married mother of three and own and run a small pet grooming business. I love my life! I would love to be able to be proud of my eyes. I have always swept my bangs to the left to cover this scar. The last 4 years
my eye lid has started to sag and droop because of
aging. The left eyelid is sagging a lot more, making
this scar alot more noticeable. I would love to see if it is possible to have my brow have a implant on the left side to match the right brow bone. Scar removal on the left eyelid and a lift so both eyes match. Thanks
Peggy Cummings
I am a middle aged woman with sagging eye lids and circles under my eyes. I also have a scar on my left upper lid that was repaired by an ER physician and not a plastic surgeon. I have always had beautiful eyes and received comments daily when I was younger. Now that I am overweight and middle aged; I no longer receive comments. I want to be pretty again and feel good about myself. I know many people who have had their eyes done by your facility and they look fabulous. In fact, I worked for a local plastic surgeon and we used to refer our patients to your office because we knew you would do a much better job. I am a very friendly vocal person and I will not be embarrassed to share my experience with others. Hopefully, this would bring your office many referrals. It would be a true honor and a dream come true if I was selected for this procedure. Thank you for being in the business of helping people feel good about themselves. PS: I tried taking new photos but I am too embarassed to post what I look like now. The photo I am posting is several years old.
Greg Davis
I am nominating my dad for eyelid surgery. We used to be able to see his eyes, now his eyelids have taken over, they are droopy, and he can hardly see. He has talked about having eyelid surgery, but it has been just all talk until now!! Now it is time to have something done about it, but we need Utah Oculoplastic Consultants help.
He as never won anything in his life, I believe winning this would be a life changing, eye opening experience and opportunity for him. My concern with him not getting this done now is, it will only progress and get worse. He has tags growing on his eyelids that he takes his clippers and clips them off himself…ouch! He wouldn’t like that I told you this, but……that’s a problem. Please help or else in a couple of years we will have to invest in toothpicks to hold his eyelids open. Respectfully yours,
Jen Schuster
Peter Denis
The skin around my eyes is so protruding and sagging that it actually gets sunburned before anything else on my face does. My eyes are so droopy that I get pollen and dust in them very easily. My eyes have become so sensitive to light I can’t bear it.Please Dr., help me with these troublesome eyes!
Jeri Nielsen
My name is Jeri Nielsen, I am 52 years old and think that overall I look and feel younger than I am, Except for one thing.
I look in the mirror and notice the bags that someone has packed for a long trip and stored them in the overhead compartment above my eyes.
I would not say that I am a vain person; however I do notice that my eyelids tend to get in the way sometimes. When I am very tired they tend to droop a bit more, could be my imagination, but it bothers me.
I have looked into having them corrected and have been told that unless you are of a certain age this is considered cosmetic and insurance will not cover it. Cosmetic or not, I would challenge whomever made that rule to take a trip through town with my eyelids. I am sure they would have a whole new outlook, assuming they could actually see.
I realize that there are bigger problems in the world. And I do not wish to convey that I think by being able to correct my droops that world hunger will be solved by any means but I do wish to impress the importance of how much this procedure would mean to me. Not a day goes by, not a hour, not a minute, that I don’t at some point think it would be so nice to be worried about something more important why this is such a deep issue for me cannot really be explained… it just is!
I heard about this contest through a friend and thought I may as well give it a try. What have I got to lose other than droopy eyes and a bit of insecurity?
Rusty Carroll
Would like my eyes to look younger, I am unemployed and I feel looking a little younger might help me
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January 2, 2012 by Dr. Matheson Harris
11 things to look for in a good doctor and how to be a good patient
The doctor-patient relationship is an interesting subject. You go to a doctor trusting they’ll give you good advice, provide expert care, and always have you best interests at heart. The doctor, on the other hand, needs you to give them all the information and cooperation necessary to make good decisions and give great treatment. Both of you must work together properly for this to all work out well. Oh, and it helps if you actually like the doctor and she or he treats you with equal respect as a partner in your healthcare decisions. We’ve all had doctors that do and don’t fit this bill. So how do we know who will be good without investing time with several visits, or even enduring poor care? There is no perfect way, but here are a few suggestions from someone who hangs out with lots of doctors.
First, do your homework. Asking your friends and family for a recommendation is a start, but after that you need to go a few steps further. Check them out online next. There are numerous websites that grade doctors (i.e. HealthGrades). I find most of these are only good if the doctor has wronged a lot of people and they have gone online to voice their concerns. Multiple bad reviews may be a sign you should look elsewhere. If half the reviews are copious exalting praise and the other half say he is Satan’s intern, you are back at square one. You can also check the state medical board for any sanctions against the doctor.
Next, when calling for an appointment, ask the secretary about the doctor’s credentials. Is he board certified or fellowship trained in the particular specialty you are looking for? If you are interested in a particular procedure, how many have they done, or better yet, how often are they currently doing the procedure? If an older surgeon, who previously did “procedure X” five times a week, now only does it once a month, he may be rusty. Can they get you in quickly, or will you have to wait a long time? A long wait may indicate you’ll have trouble getting back in to see the doctor if there is a problem. As a young doctor, I know all too well that people want someone experienced (my hair can’t go gray fast enough). What younger doctors may lack in sheer numbers of procedures performed, they may make up in knowing the most up-to-date techniques and state-of-the-art treatments (this is where talking with others who’ve had the procedure performed by your prospective doctor is helpful).
Finally, make sure the physician can communicate well with you, both listening and explaining. Discuss with your doctor exactly what they plan to do in your treatment or surgery. They must clearly explain it to you in language you understand. A recent article in the Chicago Tribune about doctor-patient communication listed the following things to look for when searching out a physician:
The Tribune stated that a good doctor:
1. asks why you’ve come and what you would like to get from the appointment.
2. shows respect to you and your family members.
3. is respectful of your time (apologizes for being late and explains why he held you up).
4. listens as much as he talks, give answers in understandable, non-jargon language, and helps you make informed decisions.
5. is scientifically up to date and willing to share his reasoning behind his advice.
6. is encouraging if you desire a second opinion.
7. makes you feel good about asking questions.
8. makes you a partner in your care, rather than just a recipient.
9. promptly returns phone calls or emails.
10. makes appointments easy to make, with minimal waiting times.
11. creates a warm environment where you can have an open and honest discussion.
On the flip side, you may have found a not-so-good doctor if he/she:
1. is dismissive of your questions and concerns.
2. leaves you feeling unsatisfied and unsure of your treatment and other issues.
3. doesn’t welcome second opinions (leave immediately).
4. is disrespectful of you, family members, office staff (a good indication that he is the reason he goes to work, not you).
5. makes you feel too uncomfortable to have an open, honest discussion.
6. has State Board disciplinary violations.
7. makes it difficult to book appointments (it can take weeks or months).
8. isn’t available to you during off hours (weekends/nights) and neither are his colleagues.
To make the doctor-patient relationship work, you as a patient can do a few things to make your appointments successful. First, be prepared. Have a list of questions you want answered. Also, keep a brief medical history with you containing a list of all your medications with dosages and schedules, any previous surgeries or major medical events, drug allergies or intolerances, and any pertinent family medical history. Printing out a copy of this to take with you and give to the doctor will give them a complete picture of your past and keep all your doctors on the same page. For an eye appointment, be sure and bring your current glasses and contact lens boxes. This can make that annoying refraction a lot quicker and more accurate.
Next, when relating your problems to the doctor be succinct and tell a clear story. We are human and can get lost just a easy as the next person when listening to a long disjointed narrative. Answer the questions asked, but don’t be afraid to give other information you may think is important. And don’t worry about asking stupid questions. I’ve had patients sheepishly ask me if some symptom is worth mentioning, only to determine it was the primary problem.
Finally, don’t be afraid to challenge your doctor on their opinion, but also be willing to take their advice and adhere to the treatment they’ve prescribed. Nothing is more disheartening than to see someone suffer unnecessarily because they are unwilling to follow the advice they’ve sought out and received. You’ve gone to them because you believed they knew something you didn’t, so give their ideas a chance.
A little homework and effort on your part can lead to finding a doctor that will take great care of you and your family, and make you feel you’re are an integral part in the process.
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