Some patients come to my office in uptown Denver and ask me "Dr Thiagarajah, as an oculoplastic surgeon, do you think I am a candidate for blepharoplasty or cosmetic eyelid surgery?". This is one of the most common questions I hear in my office with patients who may even come in for medical eyelid procedures such as skin cancer, tear duct issues or styes.

There are a couple things that prevent patients from getting cosmetic eyelid surgery. These are six conditions that limit patients from recieving cosmetic eyelid surgery from me. As an eyelid specialist I love to perform surgery but these five things will prevent me from performing cosmetic eyelid surgery on you for sure. Read the list below and ask yourself if you fall under any of these categories.

First is age. If you are not over 21, unless you were born with a congenital deformity, I will not peform surgery on you. The adult face is still growing and changing until the mid twenties and I would recommend holding off surgery if you are not old enough and your face is not developed. Period.

Second, is physical health. If you are very sick or have major medical issues those override any decision to have cosmetic surgery. Your cosmetic appearance is important but your physical health is much more important. During cosmetic surgery such as eyelid surgery or blepharoplasty, patients recieve anesthesia. Receiving anesthesia puts a patient at risk if they are not healthy enough. If you are not sure if you are not healthy or not for cosmetic eyelid surgery, speak to you primary care doctor. They can tell you if you are healthy enough.

Third, is your mental health. Active mental health problems such as body dysmorphic syndrome, active depression, suicidal thoughts, or other mental health problems prevent patients from being very good candidates for surgery. Body dysmorphic syndrome is a syndrome where patients percieve they are "deformed" or "ugly" when in reality there is nothing physically wrong with them. Cosmetic surgery will never improve those patient's mental health condition and could make things much worse. A patient who is depressed is unable to properly weigh the risks and benefits to properly consent to cosmetic surgery. If patients have suicidal thoughts that overrides everything. The bruising and swelling from recovery from cosmetic eyelid surgery is a challenge in itself and patients need to be in a health mental state to navigate it. There are moments when even mentally healthy patients will feel sad, regretful, or depressed as they heal. I need my patients to be on all cylinders mentally when they are healing. This being said, there are surgeons who will operate on anyone, but I am not one of those cosmetic surgeons.

Fourth is surgery that is not aligned with the physical problem. A patient who has a lot of crows feet will not benefit from an eyelid lift. A patient who has sun damaged skin will not look better from an eyelid lift. In short, if what the patient is complaining about is not solvable by a blepharoplasty or cosmetic eyelid surgery there is no benefit to performing the surgery. I can direct you to the correct procedure that is needed if any.

Fifth, you are not willing to wait for surgery. I am a busy cosmetic surgeon. It takes time to schedule your surgery with me in Denver. There is no way to rush things. Additionally, I make sure all patients are cleared by their doctor for health and safety reasons before eyelid surgery. There is no way to bypass this process. Patients who want to rush or bypass key steps in cosmetic eyelid surgery are non ideal candidates. These steps are for your safety and well being. Anything in life that is rushed is generally suboptimal. I want the maximum results and minimal risks for my patients and I need them to be on board with that approach.

Sixth, you don't want surgery but your wife,husband,mother, dad, etc.. wants you to have it. If a patient is not motivated to have surgery for themselves, it will be a miserable process for them. Because your husband is bothered by your eyes, it is not a reason for you to get surgery. Taking on surgery, takes on risks. Though the risks are small they are risks nonetheless. It should be you who wants surgery for yourself, not a loved one.

These are six simple things that prevent me from operating on someone for cosmetic purposes. If you are a patient who falls under these six categories I would rethink the decision to have surgery. You will find someone to do the surgery, if you look hard enough but it will not be the right thing to do.