Is Blepharoplasty Surgery Covered By Insurance?

Eyelid surgery is a frequent procedure used to improve the appearance of the face. The technique removes extra skin and fat from the top eyelids, giving the eyes a more youthful appearance. Loose skin and tissue on the lower eyelids can also cause puffy bags under the eyes, which can be removed with eyelid surgery. Eyelid surgery is deemed elective when performed exclusively for cosmetic purposes, and hence is not covered by medical insurance.

Medical insurance may cover eyelid surgery if it is judged medically essential. Heavy skin that hangs over the lash line and obstructs vision is removed with functional eyelid surgery. Excess, hanging upper eyelid skin can obstruct eyesight, making it harder to do things like drive, read, or send text messages.

In order to assess coverage for eyelid surgery, most insurance companies require proof in the form of a vision test. A board-certified eye doctor, such as an oculoplastic surgeon, must perform the vision test. If the vision test reveals that the patient has a vision problem, the surgeon takes photographs of the problem and sends them to the patient’s insurance company. The patient’s unique coverage plan determines whether the insurance company covers all or part of the cost of eyelid surgery.

Does insurance pay for upper blepharoplasty?

Though the requirements are stringent, you may be eligible for insurance coverage for upper eyelid surgery if the eyelid is obstructing your vision severely. Blepharoplasty is no longer regarded cosmetic in cases of severe drooping or ptosis, but rather a medical necessity.

How much does a blepharoplasty usually cost?

What is the price of eyelid surgery? According to 2020 figures from the American Society of Plastic Surgeons, the average cost of cosmetic eyelid surgery is $4,120. This is only a portion of the entire cost; it excludes anesthesia, operating room facilities, and other related costs.

How do you qualify for eyelid surgery?

Insurance companies will only cover the surgery if it is classified for reconstructive or functional problems like ptosis (eyelid drooping due to muscle weakness or nerve damage), blepharochalasis (eyelid swelling), dermatochalasis (excess skin), herniated orbital fat (excess fat), floppy eyelid syndrome, and visual field obstruction, according to the American Society of Plastic Surgeons.

  • You must first schedule a consultation with your optometrist to establish your requirements. Make a note of the requirement for surgery. Any of the following concerns must be documented by your doctor to establish that blepharoplasty is medically necessary:
  • Orbicularis oculi hypertrophy (enlargement) (muscles that work the eyelids)
  • Request that a surgeon take images of the issue that requires treatment. Patients will be required to sign a release form if an insurance company requests to see the photos.
  • Get all of the pre-operative diagnostic tests that your doctors recommend. These may include the following:

When is an eyelid lift medically necessary?

When the upper-eyelid skin droops down to the point where it blocks vision, commonly in the superior visual fields, an upper-eyelid blepharoplasty is regarded medically required.

When there is a lot of excess upper-eyelid skin, it can hang down and create a curtain effect on vision when you look up.

There are a variety of different disorders that can cause the top eyelid to hang down over the eye, causing visual loss.

This occurs as a result of a weakening in the tiny muscle that lifts the top eyelid. Upper-eyelid ptosis is the medical term for this disorder. Separate operations can be done in conjunction with an upper eyelid blepharoplasty to help elevate the eyelid and relieve vision restriction.

Can hooded eyes be fixed?

Is it possible to correct hooded eyelids? Hooded eyelids, which occur when extra skin sags and folds down from below the brow bone, can be treated with a blepharoplasty treatment. Excess skin and fat are removed, and the muscles and tissue of the eyelid are tightened.

How can I fix my hooded eyes without surgery?

Botulinum toxin (commonly known as Botox) injections can help you raise your brow without surgery. Simply explained, Botox injections stop the brain from sending impulses that cause the muscles in your brows to droop. This can help to smooth the skin around your brow and may lift the arch of your eyes.

Is laser blepharoplasty better?

Blepharoplasty, or eyelid surgery, can have a dramatic impact on the overall face. Patients can look younger and more alert by removing sagging eyelids or bags beneath the eyes, and they can really show off the glitter in their eyes. One of the most common concerns among blepharoplasty patients is whether the surgery should be performed using a laser or a scalpel.

Blepharoplasty, like most types of cosmetic surgery, traditionally uses a scalpel to make incisions and trim out portions of superfluous tissue. However, laser blepharoplasty is a new surgery that is increasingly overtaking the classic scalpel method in popularity, and for good reason.

What causes hooded eyes?

Hooded eyelids are typically the result of a number of age-related changes in the eyelid skin, eyebrow, underlying fat, muscle, and bone. The hooded look can hide underlying floppy eyelids (eyelid ptosis) and a droopy eyebrow, which exaggerates the hooded look. In addition to the hooded eyelid, your Plastic Surgeon should undertake a full clinical assessment during your consultation to establish if you have a drooping eyelid, a droopy eyebrow, or both.

Why is the eyebrow position an important consideration in surgery for hooded eyelids?

Because the eyebrow and upper eyelid are linked, age-related changes in the eyebrow, such as eyebrow descent or ptosis, pull down the upper lid, limiting eyelid opening and limiting the visual field. Because the outer half of the eyebrow segment has less support and gravity selectively depresses the outer eyebrow, it droops more.

Why do people choose to have surgery to correct hooded eyelids?

People who have their hooded eyelids surgically removed want their eyes to appear more open, rejuvenated, and less weary.

You would benefit from having hooded eyelid surgery if

  • Excess skin, or hooding, reduces your vision field, creates heaviness in the eyelids, and produces tension headaches.
  • The hooded eyelids, as well as droopy eyes, give you a worn and drowsy appearance.

Is hooded eyelid surgery classified as functional or cosmetic?

Hooded eyelid surgery is mostly functional in that it increases the visual field and alleviates problems including headaches and eye heaviness. The cosmetic benefits are clear, but secondary, because the eyelid is returned to a ‘normal and youthful’ appearance.

Is surgery for hooded eyelid covered by Medicare or private health fund

You will be eligible for Medicare and health fund coverage if a formal visual field test done by an optometrist demonstrates visual field restriction. Your Plastic Surgeon will examine your eyelid during your consultation and refer you for visual field testing. Lower eyelid surgery and eye bag surgery are considered cosmetic procedures and are therefore not covered by Medicare or private health insurance plans.

Benefits of hooded eyelid surgery

Upper eyelid surgery enhances vision, quality of life activities, productivity, and looks and offers functional, medicinal, psychological, and cosmetic benefits.

The vast majority of people considering eyelid surgery are ignorant of the functional benefits and believe it is only for cosmetic reasons.

Benefits following eyelid surgery for hooded eyelids

  • Improvement in eyesight and peripheral vision, as well as facial weariness induced by ptosis-related forehead muscle compensation and hooded eyelids.
  • Activities that increase one’s quality of life, such as reading and other close-work activities
  • Symptoms of pain or eye strain caused by heavy and sagging lids or brows are reduced.
  • Significant alleviation from tension headaches, as well as a better quality of life connected to headaches.
  • Following blepharoplasty, people are assessed as looking more youthful, beautiful, energetic, and healthy, according to studies.

What results can I expect after surgery for hooded eyelids?

Eyelid surgery reduces the outward indications of aging and gives you a more youthful appearance. Although the majority of the improvements are evident right away, we recommend waiting 12 weeks for all temporary changes, such as edema, to resolve before seeing the ultimate result.

Downtime following hooded eyelid surgery

  • You will be given ointment to apply to the suture line, eyedrops, ice packs, and, in certain circumstances, oral antibiotics for the first week.
  • You should stay at home for the first week. If you’re going out, you should invest in an excellent pair of sunglasses. When patients go outside, they frequently complain about the glare of the sun.
  • As directed by your Plastic Surgeon, you can begin scar therapy two weeks after surgery. Remember that eyelid scars heal quickly.
  • Silicone gel is frequently advised, however you must be careful not to get any silicone gel into your eyes.
  • Light activities are permitted for the first four weeks, after which you can resume your normal activities, including going to the gym.

Who is not a good candidate for blepharoplasty?

Those with chronic dry eyes, hypertension, circulatory diseases, thyroid disorders, diabetes, or heart disease are not good candidates for eyelid surgery. Individuals with glaucoma should see their doctor before undergoing surgery to ensure that it is safe for them.