This section contains questions asked by our patients. If you have a question about our practice that you think many would like to read the answer to, please let us know, and we’ll post your question.

Surgery Related Questions

Once I decide to have surgery, how long will it be before I can have it done? Linda M.
We try to get everyone in for elective surgery within a month of request. Of course, this varies with the time of year and the medical urgency of the situation. The more notice we have, the more we are able to provide you with the time, weekday, and facility of your choice. True medical emergencies are always managed on the same day.
How long will I be bruised after surgery and will there be much pain?
This depends entirely upon what procedure is performed. In general, bruising is gone by 7-10 days, and most patients tell us their procedures are essentially painless. Most never fill the pain medication prescriptions we routinely give them.
Do I have to have general anesthesia?

Most of our procedures are performed under mild intravenous sedation or simple local injection anesthetic. We have perfected needle administration of anesthetics to the point that it is so painless. Our practice has long been a leader in getting away from general anesthesia, unless desired by the patient. We have shown that many procedures performed routinely under general anesthesia in other practices can be performed safely, comfortably, and successfully with intravenous sedation alone.

Through lectures, publications, and hands-on training, we have taught these techniques to thousands of other physicians across the globe.

Why can’t you fix my eyelids now?
Eyelid surgery is the last step in reconstruction after a person is in the inactive phase of the disease, because orbital surgery may change eye muscle movement, and eye muscle surgery may alter eyelid position.

Consultation Related Questions

About 9 months ago, my wife had an eyelid tuck by Dr. Patrinely. She was very pleased. Recently, we were in a terrible car accident, and I went to see Dr. Patrinely for fractures around my eye. He examined me, then suggested I see Dr. Soparkar for my surgery. When my wife got out of the hospital and went to see Dr. Soparkar for a similar problem, Dr. Soparkar asked Dr. Patrinely to help with her surgery. Which one should we have seen and who is our doctor? Roger C
Although Drs. Patrinely and Soparkar both specialize exclusively in surgery around the eyes and perform many of the same procedures, there are some things that one does more often than the other. Since we want you to have the very best outcome, one physician may ask you to see the other for a second opinion or for the actual procedure to be done. More complicated procedures often require two pairs of skilled hands, and for these, the partner may be asked to assist during surgery.

Regardless of which physician you see, we hope you will think of both Drs. Patrinely and Soparkar as your physicians. One or the other is often called emergently to assist other doctors, and there have been occasions when one of the partners has needed to cover some of the other’s office visits. We will make every effort to inform you of such events with as much notice as possible. Also, since we always have a doctor on call, after hours coverage of the practice is shared.

Since you are specialists, you must charge more. What are your charges and how and when do I have to pay? Shelley B.
As we are specialists, and this is all that we do, we feel it is fair to set our fees at the 75th percentile for all who perform these procedures in our location. For our training, certification, and experience, this makes are charges highly competitive.

In fact, if we perform surgery in our in-office surgery suite, there are no “facility fees,” making our costs far lower than others.

We also have contracts with over a hundred health insurance plans and offer deep discounts for our services. Therefore, as many of the procedures we perform are covered by insurance, the charges vary according to the plan.

Unfortunately, most insurance plans do not cover purely cosmetic surgery. Therefore, in such situations, we ask all professional fees be paid in advance of the surgery. If you are from out of the country, we request cash, bank check, or money order.

I have a young child that I need to bring with me to the office. How long is the wait usually to see the doctor? Millie P.
We work very hard to keep wait times below 15 minutes, but we are not always successful.

All it takes is one person to arrive with a life-threatening or vision-threatening problem that we had not been expecting, or one emergent call from a physician operating nearby who has gotten in over his head, for us to fall 45 minutes to an hour behind.

There are two things you can do to minimize your wait:

First, when you call for an appointment, tell us as much as you can about why you are coming to see us. This helps us to schedule our day more precisely.

Second, before you leave your house or hotel, call us to be sure we are running on time. Things may have changed by the time you arrive, but chances are better that your wait will be short.

Finally, if you do have to wait, be assured that when we do see you, we will take as much time with you as you need.

The receptionist told me it would be two months before I could get an appointment. How do I get in sooner? Chuck W.

We always work very hard to be available to people in a timely fashion. However, at certain times of the year, or when we leave town to lecture, even though we often extend our clinic hours, we can get terribly backed up.
If you are an established patient with a problem, our policy is to see you the same day.
If you are new to our practice, there are several ways you can get in to see us sooner:

1.)If you are being referred by a physician for a medical problem, have your doctor call our doctors personally to explain the situation.
2.) If you can be available on short notice, ask our receptionist to put you on our “short call list” and provide a pager or cell phone number where you can be reached. This is an excellent way to have your surgery moved up as well.
3.) Be flexible about which physician you will see. When one of our doctors is out of the country lecturing, for example, his schedule may fall behind by several weeks, and his partner may work extended hours during this time. Our doctors frequently work interchangeably, so if you are willing to be seen by one for a pre-surgical consultation with the other, we can often accommodate you more quickly.
4.)Finally, don’t hesitate to explain why your situation puts you in a time bind, and perhaps our receptionist will be able to work some magic.

I don’t want to be seen waiting in a cosmetic surgeon’s office where I might be recognized.
Your privacy is of paramount importance to us, and we have designed our offices with this in mind.

In general, our waiting rooms are small and well sequestered from the view of people walking by. Our sign-in sheets are designed so no one can see the names of our other visitors.

If you wish for further anonymity, request a first appointment time and ask to be brought back to one of our examination rooms as soon as you arrive.

Personal security personnel may accompany you into the exam and procedure rooms, but if you desire to have the entire office surveyed, you will need to schedule your appointment when there will be no other patients, since we cannot allow your security personnel to infringe upon the privacy of other people.

Treatment Related Questions

The doctors tell me they fixed my thyroid and that it is now normal. Why are my eyes acting up?
The thyroid gland and the eyes are independently affected by one or more autoimmune antibodies circulating in the blood. The eyes don’t cause the thyroid troubles, and the thyroid doesn’t cause eye problems. Correcting thyroid hormone levels has very little, if any, impact on the Thyroid Eye Disease in most people.
I’ve been told I have both Grave’s Disease and Hashimoto’s Disease, which do I really have?
Many people and physicians use the terms Grave’s Disease and Hashimoto’s Disease incorrectly. Typically, physicians use the term Grave’s Disease to mean a hyperthyroid condition and Hashimoto’s to mean a hypothyroid condition. Both are caused by autoimmune antibodies, some of which stimulate the thyroid causing hyperthyroidism and some of which inhibit the thyroid causing hypothyroidism. Still, many people can have multiple autoimmune antibodies, we prefer the term autoimmune thyroid disorder to encompass all of these conditions.
Steroids made my eyes much more comfortable. Can’t I just continue taking them?
Steroid therapy may be effective in masking the inflammatory phase of Thyroid Eye Disease and partially shrinking the muscle swelling; however, the side effects from steroids are very common with continued treatment and other long term treatments or surgeries should be considered.