Blepharoplasty is the cosmetic or therapeutic removal of excess skin of the upper and/or lower eyelids. As they get older, many people will find that their upper eyelids will begin to droop. They will become so heavy that the skin will visibly cascade over the eyelashes causing a loss in the visual field. For people experiencing this sort of visual defect, insurance will often cover upper eyelid surgery. In order to determine whether a significant visual field defect exists an optometrist or opthalmologist can perform a simple test which will determine how much can be seen by the patient. The results of this test along with other factors of the physical examination will usually determine whether a medical condition exists for insurance coverage of this type of corrective surgery.

Surgery of the lower eyelids is usually determined to be cosmetic only; however, a physical examination is necessary to make a determination.

Whether eyelid surgery is cosmetic or corrective, the procedure is done in the same manner. The surgery is performed at an outpatient surgery center under a general anesthetic. Patients go home the same day and are seen at one and two week intervals for follow up. Patients are followed for 6 months to a year afterward

F.A.Q.

 

Q:     My upper eyelid skin is hanging down and droopy.  It makes me look like my eyes are closed.  Both my mom and I have this family trait.  I am in my 40's and my mom is 65.  Is there anything that can be done for this and will my insurance cover it?

 

A:  There is a medical term for what you are describing which is dermatochalasia.  It is a condition where the upper eyelid skin hangs down toward the eyelashes and may even droop over the eyelashes.  Excess skin on the upper eyes can give you the feeling of heaviness and can make your eyes look smaller.  When this condition is severe, there can be some loss of peripheral vision because the excess skin blocks the full range of vision.  When the severity of the condition reaches this point, most insurance carriers, including Medicare, will usually cover the cost of the surgery to correct this problem.  There is a simple and painless test that can be performed by your regular vision care specialist that can help determine whether you are experiencing vision loss.  As a general rule, if your examination reveals that your eyelid skin rests on your eyelashes when your eyes are open, there is a chance that you are experiencing some peripheral visual field loss.  Surgical correction of this problem is perfomed on an outpatient basis and takes about an hour.  You will need to limit activities for about ten days and there is little or no pain for most patients.  As for the ideal time to perform this surgical correction, if there is a loss of peripheral vision, the time is now.  For most patients, the results are long lasting and will typically not need to be repeated.  For many patients, this procedure will not only improve vision, but will also improve ant aesthetic appearance of the face.

 

Q:  Can my surgery be performed in the office under a local anesthetic?  I am nervous about being put to sleep.

 

A:  In some cases, yes.  Much of this decision-making process is between the patient and the physician and Dr. Kiesnowski can give you an opinion on whether or not your are good candidate for an in office procedure vs. a procedure performed in the operating room.