CORRECTIVE PLASTIC SURGERY
People come to us from across the United States and around the world to correct the results of others’ attempts at plastic surgery. As much as 60% of our work is repairing work done by other surgeons. Of course, nobody intends for their patients to have a suboptimal outcome, but unanticipated wound healing issues, relative inexperience working around the eyes, the use of outdated techniques, performing exactly the same surgery for everybody, and combining too many overlapping procedures are some of the common causes of problematic results.
The eyelid tissues are among the thinnest and most sensitive in the entire body. Many problems affect the eyelids first and most profoundly. Systemic allergies, for example, may cause severe changes in the eyelid skin that are subtle to the uninitiated observer and visible nowhere else. However, most wound healing problems are predictable and should be carefully considered prior to any surgical plan. Prior irradiation or chemotherapy, severe sun exposure, Rosacea, sebaceous hyperplasia, diabetes, Psoriasis, vascular disease, autoimmune disorders, heart disease, high blood pressure, scarring, previous nearby surgeries, hundreds of medications and supplements, and numerous skin conditions are all common causes of potential wound healing problems.
INEXPERIENCE WORKING AROUND THE EYES
The average plastic surgeon in the United States performs less than 25 eyelid surgeries a year. Each of our surgeons may perform well over a thousand each year. Experience truly does count. There are so many commonly made mistakes by otherwise excellent plastic surgeons who simply haven’t done surgeries around the eyes that it is difficult to choose just a couple to highlight. Perhaps one of the most common is failure to recognize underlying asymmetries in eyelid heights or eye positions. An eye that is farther back in the head will become much more noticeably disfiguring when the otherwise more distracting extra tissues are sculpted away. Another very common problem is removing too much lower eyelid tissue in an attempt to “remove all the wrinkles.” There is a very big difference between “wrinkles” from too much skin and “wrinkles” from tissue paper-thin, damaged skin.
USING OUTDATED TECHNIQUES
Like everyone else in every other walk of life, it is difficult for a plastic surgeon who “specializes” in the whole body from liposuction of the thighs to abdominoplasty to breast augmentation to rhinoplasty and facelifts to stay current on eyelid techniques. Show us a surgeon who truly follows the specialty journals and regularly attends specialty conferences in each of these areas, and we’ll show you a surgeon who has no time for patient care. Even facial plastic surgeons may be challenged. Many surgeons also fall into a “comfort zone” of using techniques in which they initially trained, and it becomes difficult for a person seeking a surgeon to balance decades of experience against the use of old techniques. Some commonly seen outdated, problematic techniques include excessive removal of lower eyelid fat during blepharoplasty, attempting to raise the lower eyelid by tightening the outer corner, and the use of free fat grafts into the lower eyelid.
THE SAME SURGERY FOR EVERYBODY
We are always puzzled when a person comes to us complaining about someone else’s surgical outcome and says they were told by their surgeon, “I don’t know what went wrong. I do exactly the same surgery for everyone. There must be something different about you.” At first, this may seem ridiculous, but in fact, it happens all the time. A surgeon who is rushing along, neglecting their office notes will default into a “typical” procedure, ignoring differences in age, gender, race, skin type, general health, body weight and size, facial structure, etc. To account for and camouflage common facial asymmetries, we don’t even do the “same” surgery on two eyes in the same person.
COMBINING TOO MANY PROCEDURES
Like the salesman who believes he can’t let you leave the lot without buying a car, some surgeons believe they must do everything in the face at one time, or they might lose the opportunity. Likewise, sometimes the plan for doing “one surgery all at once to fix everything” is pressed by the patient. However, it is essential to remember that the entire face and head are parts of a continuum. Moving the brows or forehead, altering the nose, tightening the neck, jawline, or face all impact the eyelids with a multiplicative rather than additive effect. Further, things may look very different to the surgeon when a person is lying on their back during surgery compared to how they look under the influences of gravity when the internal suspending sutures eventually dissolve.
BALANCING EXPERIENCE WITH NEW TECHNIQUES
At Plastic Eye Surgery Associates, our physicians have earned a strong international reputation for extraordinary excellence in their field. Drs. Patrinely, Soparkar, and Murdock are highly skilled and experienced surgeons who have developed numerous novel techniques now commonly used among oculoplastic and plastic surgeons throughout the world.
Plastic Surgery is both a science and an art. Gathering and analyzing data from our nearly 150,000 procedures and carefully reviewing the complications of others provides the framework for the science that helps us constantly improve our techniques and outcomes. Listening carefully to each patient’s unique goals and customizing every single surgery is part of the art.
BEFORE AND AFTER CORRECTIVE PLASTIC SURGERY PHOTOS
APPOINTMENTS IN HOUSTON, THE WOODLANDS, PENSACOLA, AND DESTIN
If you would like to consult with Dr. Patrinely and Dr. Soparkar about a plastic surgery procedure, contact us. We have offices in Sugar Land and The Woodlands in Texas and Pensacola, and Destin in Florida to serve you.