Eyelid Lifts-Fine Line Between Cosmetic and Therapeutic-by Dr. Mark Bishara, MD
Eyelid Lift Surgery
Drooping eyelids may seem like a common effect of getting older, but sagging eyelids not only age someone's face, but they can also impair peripheral vision too. Removing the excess skin through surgery can both improve vision and result in a more youthful appearance, but determining whether the procedure is cosmetic or medically necessary has become a point of controversy. Dr. Mark Bishara, with offices in Mansfield and Southlake, offers eyelid lifts (also known as Blepharoplasty) among his cosmetic services.
Eyelid lifts, called blepharoplasties, are done when the upper eyelid, which usually hangs about 2mm above the pupil, starts to sag. It can be removed for cosmetic reasons or because it starts to block a person’s peripheral vision.
Does Insurance Cover Eyelid Lifts?
An increase in eyelid lift surgeries covered by Medicare has risen. According to the Center of Public Integrity, Medicare can pay $574 to $640 per eye. There are no national Medicare criteria for what determines a functional blepharoplasty. Different Medicare contractors that cover different regions of the country have their own criteria, but were fairly uniform across the country.
For Medicare to cover the surgery, a doctor must perform two vision tests, which measure the degrees to which a person can see peripherally from the horizon. The surgery would have to theoretically improve a patient’s peripheral vision by a specific number of degrees to be approved. The number of degrees depends on what is required by the individual Medicare contractor.
Other private insurance companies often use the same criteria as Medicare to determine if an eye lift is necessary. For example, United Health Group, one of the largest private U.S. health insurance carriers, uses the Medicare guidelines to determine if a blepharoplasty is medically necessary or if it is cosmetic.
A photo of the patient also has to be included to show that he or she has sagging eyelids, and the patient must report additional symptoms, such as headaches from straining their eyebrows or injuries from running into things they can’t see. One common early sign was difficulty reading. At the end of the day, the eyelids might become so heavy they can’t open them.
What to Know Regarding Eyelid Lifts:
As with any type of surgeries, there are risks and complications involved in the procedure. Below are just a few of the risks that are involved and they may, or may not, affect the patient:
• Slow process of recovery
• Visible whiteheads after stitches are eradicated
• Impermanent swelling of eyelids
• Loss of vision or damage to eyes (rare risk)
• Closing the eyes while sleeping might be difficult (normally temporarily)
• Blurred or double vision
• Irregular scarring or healing
People who are considering eyelid surgery should also learn about the medical conditions that make it more risky for them, such as:
• Thyroid problems – Hypothyroidism or Graves’ diseases
• High blood pressure or other types of circulatory disorders
• Lack of tear production or dry eyes
• Disorders of blood vessels and/or heart disease
People who are opting for eyelid lift surgery have the option of going through a laser eyelid surgery, but the risks and complications are said to be higher than the traditional surgery. It is advisable for patients to research various surgeons and medical centers prior to the surgery. Obtain as much information as possible to avoid any unwanted discrepancies after the surgery. Research can be done via the Internet, which is easy, quick, and informative.
Dr. Bishara provides a wide range of cosmetic procedures, including Blepharoplasties, to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. Please call our office for more information at (817) 473-2120.