Sometimes when I am bored, I look up medical advice sites and try to answer some basic questions about eyelifts or blepharoplasty. Some questions are interesting and make me think about my patient's needs. As an oculoplastic surgeon in Denver, I also answer questions when I can on realself, make me heal and other medical advice websites. That being said, I have found three groups of questions which I try not to answer for very specific reasons. If you are thinking of asking one of these three categories of questions, think again. Read ahead to see what they are and why I don’t answer these questions.

1.If you are under 21….no, there is not a doctor here who is going to advise you to have cosmetic surgery

One of the most common questions I see on Real Self are questions from children about cosmetic concerns. The first rule is that no plastic surgeon in their right mind is going to perform a cosmetic surgery on the face or eyelids on someone under 21 unless there is a medical issue going on. The reason that surgeons don’t operate on children for cosmetic concerns are that the face is not completely formed or developed until a patient’s mid 20s. Performing surgery on a 14 year old for example may necessitate further surgery once the child’s face is fully developed. It makes much more sense to perform the procedure once the face is developed so only one procedure is needed. Also, children really can’t consent for cosmetic surgery and other than rhinoplasty, most plastic surgeons would question eyelid surgery for example being done on a child by another surgeon.

2.. If you have a question about recovery after your eyelid surgery or facelift, you need to talk to the surgeon who operated on you

When you have surgery it is the responsibility of the surgeon performing the surgery should answer questions about your healing. If there is something that is not going right the person you should contact is your original surgen. This is especially true the first three months after a procedure. The original surgeon knows your procedure, your anatomy and what has happened during the surgery. Asking a group of random surgeons to look at a photograph and ask “is this normal?” is not doing you a service. Save the question for your regular surgeon. This also applies to botox, juvederm, fillers and other non surgical procedures.

3.Trying to get medical advice about treatment or what procedure you should get with a photograph and a patient description is not giving you a good idea of what you need

There is a reason that telemedicine has not taken off. One needs more than photos, videos and a description from a patient to determine what is going on. Remember especially for eyelid surgery or facial surgery in general the surgeon needs to see how your face and eyelids move. Does the eyelid close properly? How do they open? What is the function of the facial muscles? Is sensation intact? This is why a plastic surgeon needs to examine you before recommending a certain procedure.

Let’s look at eyelid surgery for example. There are so many things such as eyelid muscle function, how the eyes close, dryness of the eyes, tear film, pupil size, eye motility among some that have to be determined by an exam by a doctor. It is impossible to determine this from a photograph, video and description.

So what happens? A patient goes to real self , make me heal or some other medical advice site sends a photo with a description and some well meaning surgeons try to answer the question or recommend a procedure. The patient then goes and sees a doctor who recommends a different procedure because the plastic surgeon you see in their office has ten times the amount information than an online doctor. Then as the patient you are confused. You go back to the online plastic surgery advice site and ask further questions to which you get more conflicting advice. All in all, this does not help the patient but only hurts them.

There is a reason that a consultation is needed to determine what surgery is needed and why a surgeon needs to examine a patient before operating on them. These websites will help patients answer basic questions but personal advice on each individual case is foolish in my opinion.

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