Is Ptosis Surgery Part of a Blepharoplasty or is It a Separate Procedure?

  Ptosis surgery is needed if the muscles of the upper eyelid are weak, whereas blepharoplasty refers to the need to remove extra skin and fat for medical or cosmetic reasons.  The two procedures are unquestionably distinct and not part of one another.  Nevertheless, the procedures may be performed at the same time BUT only by experienced oculo-facial plastic surgeons.  You would NEVER want any other specialist to do a ptosis repair although many specialties do perform blepharoplasties. 

Ptosis surgery is where the upper eyelid elevating muscle is tightened to lift the height of the lid (distance of lid margin where lashes are to the pupil). It truly opens the eyes. This can be a cosmetic or functional surgery depending on degree of lid droop. This is more complex than standard blepharoplasty surgery in which skin and fat are addressed (reduced). A poor outcome to ptosis surgery can be a lifelong problem so make sure to see an experienced ptosis surgeon for this. By and large these are oculoplastic surgeons only. Best,  Dr. Massry

Upper lid blepharoplasty is a surgical procedure to remove extra skin and fat of the upper eyelid = dermatochalasis.  This can be cosmetic or functional meaning that there is enough extra skin and fat that it affects the superior field of vision.  Ptosis repair is a surgical procedure to correct low eyelid height which is resulting in loss of superior field of vision.  Ptosis repair can be deemed by some insurance companies as being cosmetic if the eyelid height isn't low enough for their standards or if the visual field fails to demonstrate loss of field of vision.  Your eyelid surgeon should be well versed in what insurance will cover and won't.  If it is possible that they may, then taped/ untaped fields should be performed and photographs taken to send to the insurance company.  Some plastic surgeons do not deal with insurance companies and may not give this option of it being covered and go through the pre-auth/cert process.  Furthermore, it is possible to have both dermatochalasis and ptosis and to need both a ptosis repair and blepharoplasty performed at the same time.  A cosmetic blepharoplasty may be done at the time of ptosis repair.  Some surgeons include this with the ptosis repair.