A patient seeking blepharoplasty needs to meet certain criteria to have the procedure covered by insurance. This includes being in good health, avoiding excessive smoking and having realistic goals.

Cosmetic eyelid surgery can be a great option for those with excess skin around their eyes, especially for those wondering how to qualify for eyelid surgery Medicare. In some cases, it can even improve vision.

1. Consultation with a Surgeon

Eyelid surgery, also known as blepharoplasty, reduces excess upper or lower eyelid skin and improves droopiness around the eyes. It may also enhance peripheral vision in patients who have a visual field obstruction. During the consultation, you and your surgeon will discuss aesthetic goals and how to achieve them. You will also learn about surgical procedures, risks and complications, and recovery.

Your surgeon will also explain how to qualify for eyelid surgery medicare, the benefits of blepharoplasty, and what to expect, including whether or not it will address your concerns. You will also get a complete fee quote and discuss financing options if you need them

During your appointment, your surgeon will review your medical history and ask about any medications you are taking, including over-the-counter drugs, herbs, or vitamins. It’s important to be honest and detailed with your surgeon because these substances can affect your surgery, recovery, or results.

You will meet the surgical team, including your primary nurse and patient care coordinator. They should make you feel comfortable and at home. If you have any questions or concerns, write them down and bring them with you to your pre-op appointment. Sometimes one consult isn’t enough, and new questions will arise as the information sinks in. In this case, schedule a follow-up visit to ensure you’re ready to proceed with the surgery. Ideally, this will be scheduled well in advance.

2. Medical Exam

Droopy eyelids are not only a cosmetic problem, but can actually interfere with vision. To qualify for insurance coverage, the sagging upper eyelids must be obstructing the patient’s field of vision. If they are preventing the patient from driving or using telecommunication devices, then it is considered medically necessary for Medicare to cover the procedure.

The first step is to schedule a consultation with a plastic surgeon who is board certified and has experience in the procedure. During the consultation, the surgeon will examine your eyelids and assess your health history to determine whether you are a good candidate. They will discuss your goals and expectations for the results, as well. Dr. Dean White, an experienced plastic surgeon, can guide you through this process. For top-notch care and stunning results, book your consultation with Dr. Dean White at https://deanwhite.com.au today!

During the exam, a series of standardized photos will be taken. Additionally, the doctor will conduct a visual field test to see how much your droopy eyelids are impacting your sight. This information will then be submitted to the insurance company to determine if you can receive coverage.

There are several reasons to undergo blepharoplasty. The most common reason is to improve vision. However, you may also choose to get the surgery for aesthetic purposes such as reducing puffiness or removing excess skin around the eyes. You could even decide to have double eyelid surgery, which involves creating a crease in the upper lid that not everyone is born with.

3. Field Vision Test

A visual field test is a painless and quick procedure to determine how much peripheral (side) vision you have. Your doctor will use a machine to test how far up, down, left and right you can see. This helps your doctor diagnose and monitor conditions such as glaucoma.

Your provider will sit you about 3 feet away from a screen that has a target in the center. You will have to look at this target throughout the test while your provider moves a light spot in different areas of your visual field. You will be asked to signal whenever you see the light flashing. There are many types of visual field tests, but the most common are static perimetry and kinetic perimetry. These use blinking lights to show your doctors how well you can detect them with your peripheral vision.

Other testing might include the confrontation visual field exam, which measures how well you can see in the corners of your vision. This is usually done by a specialist who will either be a neurologist or an ophthalmologist with additional training in eye problems that originate in the brain, such as nerve damage. Your eyes may be dilated during this test to allow for a more comprehensive examination of the retina, macula and optic nerve. This will help to identify other causes of your loss of peripheral vision, such as excess skin (dermatochalasis), weakness and sagging of the muscle that opens the upper eyelid (ptosis) or heaviness and sagging of the eyebrow (brow ptosis). Your provider might also ask you to take a series of photographs from various angles of the eyes to compare them at different times.

4. Photographs

Blepharoplasty surgery is a cosmetic procedure to improve the appearance of the eyes, which may also provide functional benefits for those with excess sagging skin around the upper eyelid. This surgery is also known as a “facelift for the lids.” In addition to enhancing facial contour and improving aesthetic appearance, this procedure can restore peripheral vision that is compromised by overhanging upper eyelid skin.

The procedure involves removing excess skin and fat, as well as redistribution of existing muscle or fat where necessary. Afterward, the surgeon will close the incisions with stitches. Following the procedure, patients should expect bruising and swelling that can last up to 2 weeks. Patients should follow aftercare instructions to promote proper healing, which typically includes applying ice packs and taking medications as directed.

In order for a physician to determine that eyelid surgery is medically necessary, visual field testing must be performed. This test shows if the patient has blind spots or obstructions in their peripheral vision. This test is required by Medicare as well as other private insurance payers.

For ptosis (blepharoptosis) repair, two sets of photographs are required to demonstrate the need for surgery. One set of photos should be taken in straight gaze to show that the upper eyelid is resting on the eyeslash line, while a second set of pictures must be taken with the upper eyelid elevated off of the forehead by tape to demonstrate persistence of ptosis.

Associate Professor Dean White
The Avani Building, Suite 1, Level 1/12 Nelson Rd, Box Hill VIC 3128
(03) 9895 7631
https://deanwhite.com.au