How to Qualify for Eyelid Surgery

How To Qualify For Eyelid Surgery

Dallas eyelid surgery, also known as blepharoplasty, is a plastic surgery that aims to improve the appearance of the eye area. This procedure can also improve eyesight by removing drooping eyelid skin that may be hanging low in the patient’s line of vision.

Often because of the aging process, sun exposure, or sometimes genetics, individuals have excess fat and skin on their upper or lower lids. Different variations of eyelid surgery can alleviate these problems, leaving the patient looking and feeling younger and fresher.

If you have been considering a procedure to improve the appearance of your eyelids and eye area, you may be wondering how to qualify for eyelid surgery. Let’s take a look at the various qualifications your plastic surgeon will be looking for.

How to Qualify for Eyelid Surgery

Before we dive right into the required qualifications for eyelid surgery, we first must make a distinction between the general requirements that your plastic surgeon will be looking at and the requirements dictated by insurance companies.

Plastic surgeons have their own set of requirements for blepharoplasty patients. These are mostly health-related. Patients must be in good overall health with signs of aging or genetic-related abnormalities in the shape or drape of their eyelids and eye area.

It’s important that patients are non-smokers or quit smoking prior to their surgery. The majority of blepharoplasty patients are between the ages of 40 and 80, though we also see patients younger than this at times. Finally, patients should have realistic expectations concerning their results.

Medicare and Insurance Qualifications

In addition to the above requirements, many patients are interested in learning more about how to qualify for eyelid surgery through their insurance company or Medicare. Health insurance companies, including Medicare, will sometimes cover all or part of eyelid surgery because this surgery is routinely performed to improve a patient’s vision.

At this point, it’s important to note that all health insurance companies are different and have different policies concerning the restorative surgeries they will and will not cover. Furthermore, if a health insurance policy says that it will cover a “medically necessary” blepharoplasty, the company’s specific definition of what a “medically necessary” blepharoplasty looks like will also vary.

As a general rule, a patient must have a field of vision obstruction of at least 30 percent (12 degrees) in order to get coverage for blepharoplasty. This will be determined by a visual field test, which must be performed by a licensed ophthalmologist. 

Patients must also prove that they have had visual issues prior to their interest in blepharoplasty. These issues must be carefully documented by a reviewing physician, who must also recommend the surgery to amend the patient’s vision.

Keep in mind that if you are interested in getting blepharoplasty because you don’t like the appearance of your eye area or because your eyelids are drooping in a way that you find aesthetically unappealing, these reasons do not qualify you for insurance coverage. Health insurance companies, including Medicare, do not pay for cosmetic surgeries performed for aesthetic reasons.

What Does Eyelid Surgery Entail?

How To Qualify For Eyelid Surgery MedicareEyelid surgery can be performed several different ways, depending on what the main concerns of the patient are. Because of the delicate nature of the eye area and the fact that a patient’s vision may be implicated if complications occur, eyelid surgery requires extensive preparation and particular care.

Once you are cleared for surgery, you will schedule the date of your procedure. Many patients opt to receive general anesthesia before undergoing this procedure because it can be a rather anxious experience to get surgery on the eye area. Still, local anesthetic with an IV or oral sedation can also be offered.

Once anesthesia and/or sedation have been administered and the patient is comfortable, your surgeon will make his or her preplanned incisions and remove the excess eyelid skin and/or fat. The procedure changes slightly, depending on whether your surgeon is performing surgery on the upper eyelids, on the lower eyelids, or on both areas.

When eyelid surgery is being performed on the lower lids, it is usually fat that is taken out or redistributed. As your surgeon removes the excess fat, the muscles in this area may be tightened as well. 

For upper eyelid surgery, it is usually excess skin (and sometimes fat as well) that is removed to correct droopy eyelids. Once the upper eyelid skin, lower eyelid skin, and/or fat are successfully excised, your upper or lower eyelid surgery incisions will be closed up, and you’ll be taken to a recovery room.

FAQ: Qualifying for Blepharoplasty

How hooded does an eyelid need to be to qualify for surgery?

In order to know if you will qualify for eyelid surgery coverage via your health insurance provider or Medicare, you must undergo an ophthalmologist’s visual field test to you see the extent of your visual field obstruction. Generally speaking, you must show proof of a 30 percent visual field obstruction (12 degrees).

How do I know how to qualify for eyelid surgery Medicare will pay for?

Medicare generally requires proof of a 30 percent visual field obstruction (12 degrees) before it will cover blepharoplasty. You must also have documentation of visual impairments and a recommendation for blepharoplasty provided by a physician.

Can botched upper eyelid surgery be corrected?

Yes, most of the time, a skilled plastic surgeon will be able to correct botched blepharoplasty with revision surgery. To avoid a botched surgery in the first place, always be sure to choose an experienced, board certified plastic surgeon.

Schedule a Consultation Today

How Hooded Does An Eyelid Need To Be To Qualify For SurgeryThe only way to know for sure if you are a good eyelid surgery candidate is to call and set up a consultation appointment with Dr. Raja Mohan.

Dr. Mohan is happy to meet with you at your convenience to discuss your medical history, any current health conditions, and your surgical goals. Dr. Mohan will also examine your eyelids and eye area to determine your best course of treatment.

To schedule your consultation appointment today, please give our office a call.


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