2: My Eyelid Surgery

In my last article about plastic surgery I mentioned that I was interested in more aggressive and permanent changes to my appearance than injections could provide. It took me six or seven months and a lot of wavering, but I finally had surgery yesterday afternoon! I will write about it in detail here since I know many of you are interested in it.

Before and after photos are always interesting. I struggled with this, but I decided to be brave and share pre-surgery and post-surgery photos. These are graphic, there is also no makeup, and I look ugly. It's not the Pammy you know. Consider this fair warning if you are squeamish about surgical stuff.

What I Wanted Changed.

I have always had "hooded" eyes. "Hooding" happens when the skin above your eyelid crease falls over the crease onto the eyelid. This skin covers the crease like a hood and makes the eyelid smaller. Having hooded eyes is a mixed blessing. On the one hand, hooded eyes can be sexy. Our gorgeous SheDaddy has them, and there is no one with more beautiful eyes! On the other hand, having hooded eyes makes some makeup techniques trickier and others impossible. Winged eyeliner is a classic example. You draw a perfect wing only to discover a black makeup spot above your crease when you open your eye. It's caused by the overhanging hood contacting the winged eyeliner when your eye is open, showing as a flaw when you close it. There are ways around this, and with a little makeup razzle-dazzle, anyone can sport most looks.

Most people with hooded eyes live with them and enjoy them enough that they don't consider surgery. That only works for a while because the hood tends to grow bigger with age. In my case, it became quite extreme, covering most of my eyelid and almost totally obscuring the crease. My eyes are well past the point where the hooding could be considered sexy.

I wish I could say that was the only problem, but I don't care much for my lower eyelids, which sport gigantic bags. They are gross without makeup. Here's a pre-op picture:

Upper and lower pre-op eyelids.

I'm facing you here, so my right eye is on your left. Arrow "A" points to the crease. The skin above the crease has grown to such an extent that it now covers almost all of my upper lid, including my lashes and most of the crease, as shown by arrow "B." The hooding of the left eye is even worse, although it's a bit hard to see from this cell phone selfie.

"C" points to the lower boundary of my humongous lower-eye bags. The lighting is a bit favorable to them in this photo. They usually do not look even this good. Yeuch.

Many people I have talked to about this say they have never noticed these problems from meeting me or seeing my Gallery Photos. If that's true (and they are not just being lovely), all I can say is, "Thank you so much!" I worked hard to acquire the makeup skills to be able to minimize and hopefully defeat both of these problems. But it has become a nightmare for me. And there are some looks I would love to try but can't because of the excessive hooding. It's beyond anyone's makeup skill. That's why I crave eyelid surgery.

How it Gets Changed.

The surgery to correct these defects is called a "blepharoplasty." (Greek "Blepharon" meaning "eyelid" and the surgical suffix "-plasty" from Greek "plaston" meaning "to form.") Subdivided into upper and lower blepharoplasty, depending on which one needs repairing.

To repair the upper eyelid issue, the surgeon must cut away the excess skin and stitch the rest of the parts together. Fatty pads cause the "bags" on the lower lids just under the skin. Many surgeons remove the pads altogether; that was the procedure when this surgery was first pioneered and is still quite common. The problem with this is that those pads are there for a reason: the skull has depressions right below your eye, and if there is no fat there at all, you swap eyebags for sunken eyes. It is hard to decide which is less attractive - neither is desirable. I discussed this issue with my surgeon before the procedure, and we agreed he would trim and move the pads to get a more natural result.

Decision Making

I've never really liked my appearance as a man. I think Pammy is gorgeous, but my boy look, not so much. As the appearance of my eyes worsened, I just shrugged and accepted it as yet another flaw in an already flawed picture.

Enter Dom De Luxury, AKA SheDaddy, and my inevitable transformation into her creation, Pammy. As she has helped awaken my inner woman, things like overly-hooded eyes, thin lips, and not enough cheekbones have gone from things I tolerated with an unhappy shrug to things I can't live with anymore. So I decided last year to look around for a surgeon for eyelid surgery, but it has taken quite a while to find one.

I had narrowed the list down to a few candidates but had no good way to decide among the finalists. That's when a minor medical problem provided the surprising answer. I developed a small case of what is known as 'entropion,' where your lower eyelid curls inward and rubs against your eyeball. Not only does this irritate your eye, but it can also be dangerous to your eyesight. I needed to get it fixed. My insurance will pay for entropion correction, and one of the best guys for it is on my plan and in my town. (For those of you who don't know, I live in one of the most dysfunctional healthcare cities in one of the most dysfunctional healthcare countries in the world.) In my initial visit to consult about the entropion, I brought up the issue of my cosmetic unhappiness. As we talked about it, I was very impressed with him, and we decided to have all these procedures done simultaneously. Why spread out the misery?

SheDaddy never pushed me to do this, but she agreed and beautifully supported my decision. She understood everything, the desires, the fear, the worries. It is amazing to have someone like her mentor me on this path. Without her on my side, I am sure I wouldn't have found the courage to go through with it.

When and How Much

Post surgery, you look awful. Therefore, you need to find a two or three-week window where it won't matter that you look like you just got mashed to potato pulp in a bar fight. Or wear dark sunglasses a lot. Or both.

"How much" is a lot. Technically, it is four procedures: two top lids and two bottom lids. With my entropion on each eye, that makes six. You are right if you think that will be quite the price tag. Average costs in my area are $6,000/eye for the upper lid and $4,000/eye for the lower lid. That's $20,000 (woo) and could be even more if your surgery is more complicated or your doctor more expensive. But costs vary widely by geography, so check in your area. It would be very unusual if the costs in your area weren't lower than the ones here.

To help deal with the expense, my surgeon suggested I get a visual field test. It turns out that if your eyelid is extremely hooded, it can interfere with your vision. If it interferes with your vision, then insurance will pay for it. I flunked the visual field test; how about that? Insurance was also paying for the correction of the entropion. That left the lower lids. There was no way to disguise this as anything but vanity. However, my doctor was old-school and thought he was already making enough money, so he did both lower lids for only $4,000. An awful lot of money, but less than the $20,000. Who says it's never good to flunk a test? Would I have still done it if I had to pay the full cost? I can only say: Maybe. I'm just grateful I didn't have to make that decision.

Pre-op, OP, and Post-op

The pre-op preparation is pretty much the same as it would be for any surgery. You need surgical clearance, which involves blood work, an EKG, etc. All the usual crap before surgery: no blood thinners, don't drink, if you take meds, figure out what to do with those.


I was surprised to learn that they don't use general anesthesia for this surgery. Not as awful as it sounds. It isn't awful at all. They inject local anesthesia around the eyes and use intravenous sedation to keep you calm, but you will be awake. They place opaque contacts over your eyes, so you won't see a sharp scalpel as it works on your eyes, and gently wrap your arms and legs on the surgical table. I found the whole experience very comfortable and interesting, as I could hear the surgeon talking about stuff as he went along.

I know this will freak some of you out. You can probably get it if you want to be asleep for the whole thing. But before you go that route, consider why this is a bad idea. Your surgeon shapes your eyes based on how you look when awake. You want to maintain muscle tone around your eyes, and the surgeon may even want you to look up or to the side at various points of the procedure. You can't do that if you when knocked out with a general anesthetic. Your muscles will be completely slack, a horse of a different color. All the surgeons I talked to agree that using general anesthesia will work against having the best possible outcome.


It won't surprise you to hear that you will be hurt and bruised after your surgery. Here's a photo of both of my eyes about one hour after surgery:

One-hour after surgery.

A rare chance to see Pammy without makeup, so enjoy it. Note the sexy Charles Manson Vibe, courtesy of the surgeon who placed surgical marks above the eyebrows. Woo.

My lids are swollen, but you can see they are quite a bit back from their location pre-op. Let's all cheer. There is some bruising. At this point, I was in pain and took a few Tylenol to control it. I had no problem sleeping.

Here is a photo from this morning:

Morning after surgery.

I haven't needed any pain meds today. The swelling has gone down considerably, but the bruising has increased. This is typical. The redness in the left eye (on your right) is also common and nothing to worry about. I knew this because I worried enough to send this picture to the surgeon. The stitches will be in until about Thursday or Friday.

Post-op care is not that difficult. You have an antibiotic cream and some antibiotic pills you apply (for the cream) and take (for the pills) twice a day. You cold-pack your eyes every two hours (no need to do it if you are sleeping) to help reduce swelling. No exercise, bending from the waist, sex (ouch), or lifting weights greater than 5 lbs. After a few days, you switch from cold compresses to warm.

Was it worth it?

It's a bit early to answer this question. I'll have to keep you posted. Initially, I am quite optimistic. Looking at the photos, I wish he had removed more eyelid from the top, but this is already so much better. And truthfully, with the swelling, it is hard to say what it will look like in a week or two. So today, the answer is a very hopeful "yes."

Tracking my Recovery

If you're interested in tracking my recovery, check back here. I will add more photos and (if necessary) comments. This surgery was a huge decision and a huge step for me, just as I know it would be for you. I want to give you as much data as possible to help you make your own decision.

Meanwhile, you can't wear makeup for three-four weeks after this procedure, and I will be quite busy after that, so I don't know when my next photo set will be out. But maybe I can finally find a chance to do more articles on the website. I have many requests for more details on makeup, tutorials, and looks. That takes a lot of time, but maybe I can find that now. Hair requests are a close second, so I will try to find time to do something about that.

UPDATE: Stitches Out!

After stitches were removed.The stitches are out, and I look less bruised. In some ways, I look worse than before the surgery. According to the surgeon, this is because of swelling that will reduce over the next few weeks. He is thrilled (I'm glad one of us is) and expects a good outcome. I am just hoping and waiting. Here's an updated picture:

The yellowing is from the anti-bacterial ointment. Check back in a week or more for another update, and thanks for all the kind wishes!

UPDATE: Four-week check-up!

So it's been four weeks, and I went to see the surgeon today. I like this guy. He thinks things are going well but has a few concerns. These were the same things I was worried about. Unlike many physicians, he is not pretending everything is perfect. There is some swelling in the lower left corner of my left eye. It's unclear at this point if this is still post-op swelling or if there needs to be more corrective surgery. He assured me that he would be pleased to go back and fix anything that he didn't get right.

Meanwhile, there are no more restrictions. I am free to resume my normal activities; as you can imagine, I'm eager and curious to experiment with makeup again! Meanwhile, here's an updated picture. I'm sure you'll agree things are much better now!

Four week checkup

If you've had similar experiences or have thoughts you'd like to share, feel free to let me know! Please drop me a note or a dm or whatever you like!