Revision Cosmetic and Plastic Surgery
How do I treat the unhappy patient who comes to see me after having had cosmetic eyelid, facial and plastic surgery, or eye bags treatment (blepharoplasty) elsewhere? The answer is: very, very carefully!
I have now been in practice in the Tampa Bay area for over three decades. I perform hundreds and hundreds of eyelid and facial procedures each and every year, and have now done many thousands of eyelid and facial procedures. The one or two oculofacial surgeons who were in practice in the community when I first arrived have retired. This certainly makes me the single, most experienced eyelid and facial surgeon in my geographic area and almost as certainly, the most experienced eyelid and facial surgeon on the entire west coast of Florida.
Therefore, besides seeing new patients who have not had surgery, which is far less complicated, more and more often I see many patients, some from great distances, who are unhappy with the results of their surgery performed by someone else. The greatest number of these (but not all) were done by general plastic surgeons. As a general rule, the non-specialist general plastic surgeons have very little actual experience in seeing or doing cosmetic eyelid or facial surgery, and most may do only a handful of them each year. Usually, these surgeons spend most of their time doing breast augmentations, tummy tucks, and mommy makeover surgeries.
One problem with eyelid and facial surgery, different from other cosmetic procedures such as breast augmentation and tummy tucks, is that one single millimeter of extra tissue, taken or left behind, can make a huge difference in the surgical outcome. The surgical technique must be exact and meticulous and, more than in any other procedure I can think of, must be tailored for the individual patient. A perfectly performed procedure with a perfect cosmetic result can be marred if the doctor failed to account for the fact that the patient had a prior Lasik surgery, or a history of dry eyes, excessive tearing, facial weakness, facial asymmetry, or incomplete eyelid closure. And when the results are not perfect, other specialists who do cosmetic and plastic surgery may not be equipped to correct the problems which may occur. Hence; eyelid surgery, eye bag treatment, and facial surgery; should be performed by someone board certified and trained in ophthalmology or oculofacial plastic surgery, who can check for these and other problems preoperatively, and/or are trained to correct any problems which may occur.
So what do I do to treat patients who are unhappy with the results from their cosmetic and plastic surgery performed by someone else? The single most important thing I do for these patients is listen to them. I let them vent their frustration with their results and sometimes with their original surgeon. Almost without exception the original doctors did not commit malpractice; their technique was not inferior to the standard of care of the community. Instead, the results were sub-optimal, with patients angry and frustrated.
Revisional eyelid and facial surgery, blepharoplasty, and eye bags treatment are most often done to correct excessive or unsightly scarring, inadequate cosmesis, excessive (or incomplete) fat or skin removal, under or over correction, incomplete eyelid closure, severe dry eye symptoms, excessive tearing, corneal scarring or vision problems, ptosis, ectropion, rounding of the outside corner of the eye, or alteration in the shape of the eye. The surgical plan must be individualized and meticulous, the surgical technique critical, the surgical performance exquisite, if the patient is to achieve the results he or she is seeking.
Depending on when the surgery was performed, I counsel waiting for possible improvement and continued patience. Under no circumstances will I see patients who are less than one year out from their cosmetic or plastic surgical procedure. Only if the patient has waited sufficient time from the first procedure, is mentally and physically ready to undergo a second procedure, or if the health of the eye, face, or the patient’s vision is at risk, do I consider intervening sooner. And most importantly, I listen very closely to what the patient hopes any additional surgery will accomplish. I will only take on such a case if I am confident that I will be able to address the patient’s concerns and accomplish that which they hope I will achieve.
Like with any surgery that I perform (or anyone performs if they are honest with the patient), there is no guarantee of a successful result and/or of a satisfied patient. But with over three decades of experience and thousands of similar cases, I feel confident that if anyone can help with these most difficult cases, I can. So if you are upset with the results of your cosmetic or plastic surgery, have given your original surgeon a chance to address your unhappiness, and have waited at least a year from your procedure, why not contact me at the Kass Center for Cosmetic Surgery? I give you my word that I will be honest with you about your condition and will only take on your case if I believe that I can help you to achieve the results you are seeking.
Lawrence G. Kass, M.D.