eyelidDo your parents and older relatives have extra folds of skin about their eyelids, and have you started to notice the same appearance developing around your own eyes? Or, perhaps years of sun exposure and poor lifestyle choices have lead to an older look for your face that includes eyelid droop. This sagging may be genetic or the result of age and other factors, but in either case it can be detrimental to your vision, in addition to being aesthetically unpleasant. The condition can occur in women and men, and is only reversible with a plastic surgery procedure known as blepharoplasty, or eyelid surgery. In extreme cases where sagging upper eyelid skin impedes vision, the surgical procedure will restore the ability to see clearly, as well as help achieve a more youthful appearance of the eyes.

Upper eyelid skin that interferes with sight can be the most troubling since it creates multiple problems and can affect daily life. Sagging hoods the eyes, making it difficult to see anything in the upper field of vision.  If you notice yourself constantly tilting your head up to see properly, this may be an indicator that you need upper eyelid surgery to improve your vision, which your physician may deem medically necessary. In order to be a good candidate for surgery, though, you must be in good general health and not have certain ophthalmologic or circulatory conditions that may exclude you from being a viable blepharoplasty patient.

About the Upper Blepharoplasty Process

If it is determined that eyelid surgery is right for you, you will be given local anesthesia with sedation or general anesthesia during the procedure. Most blepharoplasty surgeries last between one and three hours. In most cases, eyelid surgery is considered minor and is performed in your plastic surgeon’s office-based facility, although it can also be performed in an outpatient surgery center or a hospital that the physician is affiliated with. For upper eyelid surgery, incisions will be made in the natural creases of the upper eyelids and carefully hidden. Through these incisions, excess fat, skin, and muscle are removed.

The incisions will be closed and a bandage may be applied to the eyelids temporarily to protect the site. Some bruising and swelling can be expected around the area. This will fade within 2 to 4 weeks. Some discomfort may also be felt, such as tightness or soreness in the upper eyelid. Your surgeon will be able to prescribe medications to alleviate these symptoms. Dry eyes, itching, burning, tearing, blurred vision, and sensitivity to light can also occur temporarily during the first week. After seven days stitches may be removed. Patients typically return to work soon after, usually between 7 and 10 days. Strenuous activities, such as exercise routines, may need to be postponed for about 3 weeks.

Finding Out if Your Eyelid Surgery is Covered by Insurance

Most cosmetic surgeries are not covered by health insurance since they are considered elective and not medically necessary. However, many insurance companies will cover blepharoplasty if sagging upper eyelids are causing vision problems. Typically, the following three requirements must be met:

  • Documentation (a photo) of excess skin above the eyelid
  • Proof of a clinical exam by a physician with a letter of necessity
  • Improved visual field test results when sagging skin is taped compared to when it is un-taped

The visual field exam, generally performed by an ophthalmologist, is performed by having the patient look at a series of flashing lights. He or she is instructed to push a button when the lights are seen. A computer will record how many flashes the patient saw and how many they missed, as well as false positives and false negatives. The patient’s eyelids are then taped up and the test is repeated to determine if the extra skin is blocking vision. If the results show that a drooping upper eyelid is in fact the cause of impaired eyesight, the blepharoplasty surgery will more than likely be covered. Of course, the amount of coverage depends on your insurance company. You will need to contact them to find out what your policy will and will not cover.