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Chris Thiagarajah MD

The top three questions to ask the surgeon before eyelid surgery in Denver


There are many patients in Denver, Colorado who are interested in eyelid surgery such as blepharoplasty . This is most often because they desire cosmetic improvement in their eyelids.. This is for good reason. The eyes are the window to the soul . Surrounding the eyes are the eyelids and they can alter the appearance of the eyes in a large extent. Often, when patients are interested in eyelid surgery they don't know where to begin . How do you find a good doctor? What do you even look for? I have written a book on eyelid surgery for patients that's on my website at www.denvereyelid.com . This is a great reference and tool that patients can use to determine what is the best way to find the best doctor "for them". (I'll discuss that later). That being said, there are three questions that I think are critical for any surgeon before you get cosmetic eyelid surgery with them. They reveal a lot about the surgeon and if they are a good fit for you. It is also important to understand that not every surgeon is for everyone. You should find someone who you're comfortable with and who you connect with. You don't want to be with somebody who is amazing at surgery but you can't stand to be around. If you have a complication or a problem it's been very hard for you to communicate with them and you would be more likely to try to avoid them before a problem. That being said, here are the three questions that I think are critical before getting any surgery on your eyelids.

1. Did you specializes in eyelid surgery?

Oculoplastic surgeons are specialists of the eyelid. They trained for two years specifically in cosmetic and reconstructive eyelid procedures. Knowledge of the complex anatomy and fine detail the eyelid is critical to increasing the odds of a great outcome. As one can imagine, the eyelids are a specialized organ which require a specialized surgeon . Does that mean if somebody is not specialized in eyelid surgery they are unable to perform a blepharoplasty? . No. However I would argue that eyelid specialists have the highest rate of great outcomes an lowest rate of' complications. How do I know that? In our practice in Denver we see complications from other doctors who are not Oculoplastic surgeons all the time. It is not that their intentions are bad or they are bad surgeons but they may not have the specialized training in the eyelid to optimize outcomes . Additionally, they may not have the medical knowledge for complex problems of the eyelid and the ability to catch those problems before performing a cosmetic eyelid procedure. I've had multiple patients who have been signed up for eyelid surgery by another surgeon only to come to me for an evaluation which reveals a medical issue such as a tumor , thyroid disease of the eye or tear gland inflammation . These patients don't need cosmetic eyelid surgery but in fact need removal of their tumor, treatment of their thyroid eye disease or medical treatment of their tear gland. If I was getting eyelid surgery I would request an oculoplastic surgery or eyelid specialist . There are several oculoplastic specialists who focus on blepharoplasty in the Denver area not only myself . To be totally honest I would trust my eyes in most of their hands. (There is one person who I think is terribly skilled). As a side note someone saying that they "specialize in eyelid surgery" is different than being an oculoplastic surgeon. To be an eyelid specialist you need membership in the American Society of Ophthalmic Plastic and Reconstructive surgeons. This involves a two year fellowship in the specialty. There are doctors who claim to be eyelid specialists who have not completed any fellowship but have a “interest”in eyelids. Not the same thing obviously. Just like I would not want a heart surgeon to perform any heart procedure on me I want an eyelid certified specialist to perform eyelid surgery, cosmetic or otherwise on me.

2. How many of these have you done?

Again, this is another great question. Like anything in life the more you do something the better you get. I've been performing eyelid surgery for 10 years and have performed roughly 5000 of them. Like any surgeon, every case makes me better and every case I learn from. Don't think of eyelid surgery as once someone learns the steps they can complete it on anyone. It's not like learning how to tie your shoelaces or start a car. It is a constant learning and growing and evolving skill. Surgeons get better overtime with almost any surgery that's performed. I imagine that that is applicable in many different professions. A surgeon who is 2 to three years out of training may know the basic steps but they will not have the same experience as somebody who is 10 years out of training. That is the simple truth. I would not have surgery with someone who hasn't performed at least 1000 eyelid procedures. Obviously the more the better but to be frank I'm not sure I would want a 90 year old who's done 10,000 surgeries operating on me either. These are all considerations that you should take into account along with your relationship with that specific surgeon and connection with them. If someone has comparable numbers with someone else there are going to be other factors that you will consider such as personality. Most experienced surgeons have a ton of before and after photos. The magic is not in the specific photos but that they have performed enough surgeries to have a before and after book, instagram or on their website. On my instagram I have 50 patients who have approved their photos for internet display.

3. Have you had any unhappy patients?

This question seems simple on the surface however I believe the right answer is actually counterintuitive . The truth is that the most experienced and best surgeons have had an unhappy patients. If you look at the online reviews of Paul Nassif MD you will find his overall ratings are not that great and there are some patients who are very unhappy with him . The truth is he is an amazing surgeon and excellent doctor. Most of us who have been operating for a long time have had complications that we've regretted. Most of us who have performed thousands of surgeries have had unhappy patients. The truth is that the majority of patients are exceedingly happy and are glad they had the surgery performed . There are a few patients that may be difficult to please or have had a difficult course. Some patients who have had perfect outcomes are unhappy because the eyelid surgery did not get the end result that they were seeking such as reuniting with a loved one, job promotion, or improvement in self-esteem. We try to ferret out these patients before hand who don't have goals solely on eyelid problems but some get through. That is a fact on all of us who perform any cosmetic procedure not just blepharoplasty.


Eyelid surgery or blepharoplasty is not like replacing the part in a Dodge . There is no such thing as a simple blepharoplasty. Every case is complex detailed and requires expertise. Anyone who thinks that a case is simple reflects their lack of knowledge and expertise of how specialized and specific cosmetic eyelid surgery or blepharoplasty is. I take every surgery extremely seriously and aim for perfection. In reality this is an unrealistic expectation as no one's eyelids are perfectly symmetrical and no one's eyelids are perfect however that is my goal . I want to have the highest aim for my surgeries.

In summary, these are the most common questions that I think are critical before going on to cosmetic eyelid surgery with anyone. This could be a surgeon in Denver, anywhere in Colorado or anywhere in the world for that matter. . I always encourage questions with my patience . I find that educated patients are the most well informed and are the happiest. They have extremely realistic expectations and are familiar with what I can and cannot do for their eyelids. A surgeon who doesn't want you to ask questions or shies away from questions should most likely be avoided. Transparency and open communication is critical. I hope this is helpful for you to find the best surgeon for you. If you are in Denver and interested in cosmetic eyelid surgery, I recommend scheduling a consultation with myself. As a side note, I believe that computer consultations are suboptimal and leave a lot out of the equation that results in a disadvantage for the surgeon and most importantly patient . An in person consultation gives a good idea of the connection between surgeon and patient along with a proper examination of the eyelids . For example, there is no way to know if you have a dry eye or risk for dry eye after blepharoplasty by having a zoom conversation. Thank you so much and best of luck to you.

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