I am contemplating this procedure. There is no oculoplastic expert in our area . Who should I go to for this? Purely cosmetic-- no problems with my vision. Just looking old. Should I go to an optho or plastic doc?

Facial plastic surgeon. Check out AAFPRS.org to find one near you.

Or come visit me in St Louis!

Mike Nayak, MD

Lots of specialties lay claim to the lids. No matter their original training, you want someone very experienced in cosmetic blephs. They should be able to show you dozens of 'before and after' pics that impress. It can be (usually is) done as an office procedure. I heard it is costly.

I am definitely not looking to go cheap. There are times to cut costs-- I know this isn't one of them.

I send my patients to an oculoplastic specialist. I do not do cosmetic blephs. I have managed some complications of blephs done by a local plastic surgeon. However, I have not seen any mishaps with other local plastic surgeons, so I agree with Flyn. If you need a brow lift as well or lateral brow lift with the bleph, I would suggest an oculoplastic surgeon who is skilled in those procedures. Call around and take your time in deciding.

There is no oculoplastics person there? Then take a plane to Los Angeles or New York or someplace where there are experienced, busy oculoplastics folks. The ophthalmological variety may be better, if only because they are not also doing breast implants etc. All they do is eyes, and they may be the best...

If you stay local, ask the scrub nurses or the anesthesia people. They'll tell you who does good work.