Frequently Asked Questions About Eye Lid Surgery
1. What is the difference between an upper eyelid blepharoplasty and ptosis repair?
An upper eyelid blepharoplasty is a surgery that addresses excess skin (dermatochalasis) and fat in the upper eyelid. An upper eyelid skin crease incision is made to remove extra skin and fat and recontour the eyelid. The heaviness of the upper eyelid may be so significant that it affects the superior field of vision and insurance may cover it. If it does not affect the vision then it is performed on a cosmetic basis. An upper eyelid ptosis repair is performed when there is a droop of the actual eyelid margin. An upper eyelid crease is also made in this surgery when addressing the levator muscle. An internal approach to the other muscle in the eyelid, Mueller’s muscle, may be performed in some individuals which avoids an external scar
2. How do I know if insurance will cover it or if it is cosmetic?
Dr. Parbhu specializes in eyelid surgery and knows the criteria that insurance companies use to assess for medical necessity of the surgery. This includes sending photographs and obtaining objective evidence that it is indeed affecting your field of vision through visual field testing. It is important that you distinguish whether or not you feel that it is affecting your vision when you make your appointment and want to try to use your insurance as we need to allot time for visual field testing. For patients trying to use insurance for eyelid surgery you can expect to be at our office for up to 60-90 minutes so that all testing, documentation, and counseling can be completed. This visit can be split into two visits with the visual field being performed at a separate visit.
The surgery is considered cosmetic if it is not to the extent that it affects your field of vision.
3. What can I expect at my blepharoplasty consultation visit?
At your initial visit, Dr. Parbhu will assess your periocular area and ask what your goals and expectations are for the blepharoplasty surgery. She will then be able to formulate a treatment plan that helps meet your goals. It is especially important to understand the role of eyebrow position, skin and fat in the upper eyelid and eyelid margin position.
We ask that you be ready to provide your medical history and medication list including over the counter supplements as these may thin the blood (aspirin, ibuprofen, fish oil, flax seed oil, vitamin E, etc). An eye examination will also be performed to look for conditions such as dry eye. A visual field examination may need to be done if the condition is affecting your vision and medical insurance is being used.
4. Where will the surgery take place?
If it is a functional surgery being covered by insurance, it will take place at one of the surgery centers Dr. Parbhu operates at. If it is cosmetic, it may still be done at a surgery center or may be done in her procedure room suite in her office
5. How long is the recovery and what can I expect after surgery?
Blepharoplasty recovery is variable with each individual. Dr. Parbhu published an article looking at this and found that bruising and swelling peaked around 24 hours. Following surgery you will receive a postoperative instruction sheet that discusses the use of ice for the first 48 hours to help minimize the amount of swelling and bruising. Sleeping with the head slightly elevated may also help. Bruising may last one to two weeks. The majority of your swelling should resolve in the first one to two weeks as well but in some individuals in can take several weeks for residual swelling to subside. Dr. Parbhu does ask that you avoid strenuous activity for the first week and these restrictions are usually lifted at the first postoperative visit one week after surgery when the sutures are removed. Oozing from the stitches is normal and expected in the early postoperative period. An ophthalmic antibiotic ointment is also given to apply to the wounds twice a day.