Is Eyelid Surgery Covered By Insurance? Surgeon Answers

In this video, Dr. Cole talks about eyelid surgery insurance, Ptosis Repair vs. Blepharoplasty, and how each procedure is performed. He also provides a summary of the benefits and risks of each surgery.
Congenital or Acquired Ptosis (droopy upper eyelids), which can occur at birth or later in life, is generally due to hereditary tendencies, aging changes, or trauma. Because the main reason for having corrective surgery is to improve your field of vision, this procedure is usually covered by insurance to improve functionality while having a beneficial cosmetic result.
Corrective surgery is also necessary in children who have ptosis in both eyes for proper visual development. Surgery is done in adults to improve the visual field. Ptosis is a frequent cause of “fender benders” in the elderly because of a decreased amount of reaction time when their side vision is reduced.
There are two basic surgical procedures to correct ptosis. The strength of the levator muscle in the eyelid determines which operation is performed.
TIGHTENING / RESECTION
If the opening muscle has some strength and can elevate the eyelid, then the levator muscle can be tightened or resected. This elevates the lid to the desired level.
FRONTALIS SUSPENSION
If a patient has poor strength of the eyelid muscle, tightening the muscle does not work well. This procedure uses the strength of the eyebrow muscle (frontalis muscle) to correct the droopy eyelid. A tiny silicone rod/band is passed inside the eyelid up into the eyebrow muscle where it is secured. This elevates the lid and allows the patient to use their eyebrow muscle to control the lid height. This is analogous to suspenders holding up baggy pants.
HOW LONG IS RECOVERY AFTER BLEPHAROPLASTY?
Most patients are back to their normal routines after blepharoplasty within a few days, although complete recovery may take as long as 2 to 3 weeks. While swelling, bruising, and some discomfort are all part of the recovery process, these side effects are temporary and can be alleviated with cold compresses and a mild pain reliever. OCULUS Plastic Surgery can provide further guidance and recovery instructions so you can feel more comfortable.
An eyelid lift removes excess skin above and below the eyes so you can appear more refreshed. The professionals at OCULUS Plastic Surgery are proud to have performed countless successful procedures so patients can look younger and see better. Call our Atlanta, GA, office to schedule an eyelid lift consultation and see how you can benefit from treatment.
REMEMBER to do your research when considering any type of surgery! Facial surgery, especially, is a very specialized procedure, it is essential to select a surgeon with expert knowledge in both ophthalmology and facial cosmetic surgery - Dr. Cole is board certified in both!
If you’re considering surgery or have any questions, give us a call at [phone] or go thru our website, OculusPlasticSurgery.com, to schedule your COMPLIMENTARY CONSULTATION with a quadruple board certified plastic surgeon!
Dr. Chip Cole is a quadruple board-certified surgeon based in Atlanta, specializing in ophthalmology and plastic surgery of the eyes and face-honored with The Golden Scalpel Award for Surgical Excellence.
Dr. Cole is also a fellowship instructor for two university programs, training tomorrow's surgeons, and has been honored with the Most Outstanding Faculty Award several times. Dr. Cole is frequently shares his knowledge through teaching lectures, and has been an invited keynote speaker to many prestigious universities. He is also an Amazon #1 Best-Selling author!
Want to stay home? Dr. Cole also offers virtual consultations (video visits) and is always happy to review any photos sent thru messenger or email!
Instagram @drchipcole
Oculus Plastic Surgery
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Atlanta, GA 30342
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*The content of this channel is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient's needs. Results and particular outcomes are not guaranteed.
Timecode
0:00 Is ptosis same as blepharoplasty?
0:07 What causes eyelid ptosis?
0:23 What is the difference between blepharoplasty and eyelid surgery?
0:41 Will insurance cover an eyelid lift?
0:50 Does insurance pay for ptosis surgery?
1:33 What is the criteria for eyelid surgery?
1:44 Can blepharoplasty be medically necessary?
1:58 Does insurance cover blepharoplasty surgery?

[@silaslongshot941]

My ptosis surgery was NOT cosmetic, but function gain. Right eye is 60-70% of vision, left eye 30-40%, left eye droop more pronounced & obstructed, but didn't matter due to vision so weak in left eye. So, had both eyelids 'shortened' to unblock vision. Left eye came out fine, right eye came our WORSE. Entire game was to correct vertical double vision because of ptosis causing wrinkle in cornea, causing vertical double vision., causing loss of detail in all times. Now worse as max lift of right eyelid is LOWER than before surgery. This has been an emotional disaster.
This can be "revised" or corrected? Probably result in inability to close eyelid, right?

[@c.christman9649]

I had ptosis due to overstretching during cataract surgery.

[@daisyhinojosa23]

So glad I found your channel!!! This couldn’t be a more perfect time. I’m interested in this for cosmetic purposes mainly because my upper right eyelid droops about 1mm more than my left.. What is the threshold for it to be covered by ins?

[@drchipcole]

There is not a specific measurement threshold, it would likely depend on weather or not it impairs your vision.

[@thebrennans4955]

Is just because one eye is lower mean it’s prosis. They both droop it’s just one lower

[@nitrofiche7206]

My health insurance covered my upper Blephroplasty surgery due to 30% loss of my upper peripheral vision due to acquired ptosis. Now I can see much much better. The surgery was well worth it.

[@aliceneal8666]

But I know people that had an upper bleph that was covered by insurance?

[@drchipcole]

Yes, in the event that skin in very saggy and impairing your vision, it can be covered. Is typically something that is covered with MUCH older patients.

[@sicilialicari6500]

Exactly

[@drchipcole]

😊

[@user-ff6zu3st1k]

How much for this

[@drchipcole]

oculusplasticsurgery.com/patient-resources/pricing/