Eyelid Center

Woman looking at her eyelids

Upper Eyelid Surgery

Eyelid Surgery, medically known as Blepharoplasty has become one of the most popular and often performed cosmetic procedures for both men and women because of its high level of patient satisfaction. Fortunately, Medicare and most insurance companies now cover “functional” eyelid surgery for upper lids if the vision is impaired enough to hinder normal vision. This usually occurs when the upper eyelid encroaches upon the lid margin and eyelashes. A feeling of fatigue results from the patient unconsciously trying to raise their eyebrows enough to lift their eyelids to keep the extra skin and fat pads from blocking their vision. This unconscious and involuntary lifting of the eyebrows causes wrinkles on the forehead and fatiguing of the forehead muscles which may cause the patient to feel unnecessarily tired.

 

If a patient’s vision is not impaired by their eyelids, the procedure is considered only “cosmetic” and health insurance or Medicare does not cover the procedure. If the surgery qualifies as “functional” surgery, the insurance pays for the procedure which may accomplish the additional highly desirable result of a more youthful and rested appearance. It does not, however, correct crow’s feet.

To document medical necessity for the cost to be covered by Medicare or most private insurance companies, a visual field exam must be performed. The visual field exam is done with the eyelids taped up simulating the results of the surgery, and then the visual field exam is repeated with the eyelids in their natural state to document the improvement in vision that would result from the surgery. If the procedure would result in sufficient improvement in vision, the surgery is considered functional surgery and is covered by most insurance. If the surgery would not improve the patient’s vision, it is not considered medically necessary and the procedure is considered simply cosmetic surgery only to improve the patient’s physical appearance and is not covered by most insurance plans. 

 

The good news is that something actually can be done to restore the patient’s vision since it is simply being blocked by excess skin. The skin is actually forming a hood over the eyes causing light to not reach the eyes.

Preparing For Eyelid Surgery

Before you can schedule your eyelid surgery, you will need to meet with a doctor for a consultation. During this consultation, your surgeon will be able to determine what needs to be done to correct your issue, and whether or not it will be covered by insurance. Your doctor will make sure you are healthy enough to undergo the surgery and ask about your medical history.

You will be able to ask your surgeon any questions about blepharoplasty and voice any concerns.

If you are in good health and able to safely undergo the procedure, you can schedule your eyelid surgery!

Before your surgery, you’ll be asked to:

  • Quit smoking in the weeks before your surgery. Smoking can reduce your healing rate after surgery.
  • Stop taking over-the-counter pain relievers, as these can increase bleeding. Only take medications approved by your surgeon.
  • Find someone to drive you home after surgery. You should also plan for someone to stay with you the first night after your surgery.

 

Tyson Eye will be happy to contact your insurance company for authorization for your surgery.  Most companies will not cover the costs of blepharoplasty unless it is considered “medically necessary,” meaning your baggy eyelids are impeding your vision.

During Your Eyelid Surgery

Eyelid surgery is performed in our state-of-the-art AAAHC certified ambulatory surgery center on the second floor of our main office in Cape Coral. Patients are given intravenous (IV) sedation by our board certified anesthesiologist or his team of licensed nurse anesthetists. The surgery is performed by our board certified ophthalmologists trained in plastic eye surgery.

Before the procedure can begin, your surgeon will numb your eyelids and administer intravenous medications to help you relax. How your procedure proceeds from here depends on if you are getting an upper or lower blepharoplasty. If you are having surgery on both your upper and lower eyelids, your surgeon will typically start on the upper eyelids.

On the upper eyelids, your surgeon will make an incision along the crease of your eyelid. This will help conceal the scar afterward. Through this incision, your surgeon removes excess skin, muscle and fat to tighten the eyelids. The incision will be closed with sutures.

Pre-Surgery Preparation

  • Do not take aspirin products, Advil, Motrin, Naproxen, Aleve, Ibuprofen, Vitamin E or medications that increase bleeding for 2 weeks prior to your surgery.
  • Arrive for surgery with freshly washed hair and face.
  • Arrive wearing loosely fitting comfortable clothes.

After Eyelid Surgery

After surgery you will have stitches in the creases of both eyelids that should remain in your eyelids for up to one week. Do not disturb your stitches or pull on the small bows of suture extending to the edge of your eyelids. If your sutures are disturbed they will have to be replaced by your surgeon possibly causing some scarring to result.

You will have a resting period. Once the medication has worn off a bit, you will go over aftercare instructions with your doctor once more. Once home, we recommend taking a nap to recuperate. You may experience blurred vision, watering eyes, light sensitivity, puffy and numb eyelids, and some discomfort. These side effects are all temporary.

After Surgery Care

  • Have someone to drive you home.
  • Have someone spend the first night with you.
  • Ice your eyelids for the first 24 hours after surgery.
  • 15 minutes of ice, 15 minutes no ice
  • Place sterile gauze over eyelids before placing ice
  • Apply antibiotic ointment, prescribed by your doctor, on the suture line twice a day.
  • Sleep elevated in a recliner chair or with two to three pillows to minimize swelling and bruising.
  • Do not wash your eyelids during the first week.
  • Do not wear eye makeup during the first week.
  • Avoid bending from the waist for about five days.
  • Avoid strenuous activities such as lifting and rigorous sports for about 2-3 weeks.
  • Wear dark glasses to protect your eyes from the wind and sun.

After your surgery, you should refrain from the following for the first one to two weeks:

  • Smoking
  • Rubbing eyes
  • Straining, lifting or swimming for a week
  • Using contact lenses
  • Going outside without sunglasses
  • Using aspirin, ibuprofen or other medications that can increase bleeding. Acetaminophen is suitable for pain relief.

 

Your after care is very important for a positive recovery. It is common for some swelling and bruising to occur after the surgery, but this can be kept to a minimum by conscientious icing of the eyelids and remaining upright for the first couple days after surgery. Your eyelids may also feel “tight” or “stiff” for a few days after surgery. Excessive tearing, light sensitivity and blurred vision may be experienced by some patients. With good after care, your eyelids’ appearance should return to normal within one to two weeks. Surgery does leave some scars, but they will be well hidden in the creases of the eyelids and normally fade in time. After 10 days makeup may be used to hide any remaining discoloration or scars.

Recovery

Plan to stay home a few days to allow your eyelids time to heal and your appearance to return to normal. Most patients are back to work after a week. Do not wash your eyes and do not wear eye makeup during this first week. Most patients are back to full activities after ten days. Your appearance will continue to improve for up to six weeks as the last traces of swelling and bruising go away.

 

Some patients experience dry eyes after surgery, but this condition should not last for more than two weeks unless you were also experiencing dry eye syndrome prior to eyelid surgery. If the symptoms persist advise your doctor. By six weeks the patient is considered surgically healed.

 

Recovery from blepharoplasty can take a while, depending on the patient. Bruising and swelling should subside in 10 to 14 days. Scars can take a few months to heal, protect your delicate eyelid skin from too much sun exposure.

A man and a woman standing in the kitchen together with coffee