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Is Revision Eyelid Surgery Usually Covered by Doc or Insurance?

Unhappy with my eyelid surgery due to fact that it seems to have done nothing as eye is very limp with creases still. Has been 2 weeks post op..if I speak with my surgeon, how likely is it that he will offer revision surgery pro- bono or insurance will cover it? My insurance covered it first time around.

Doctor Answers (2)

Insurance coverage.

+1

First off, it is very early for you to be worried about your post operative result, whether this is an insurance case or a cosmetic case. Wait at least 3 months before worrying about your results.

However, some information for you to digest while you wait: As your insurance covered your first eyelid surgery [blepharoplasty or ptosis repair?], it means that it was a visually significant problem. The goal of that surgery is to remove the excess eyelid skin [or raise the eyelid via ptosis repair] so that you can see better  [improving your visual field]. Your insurance will cover the surgery because it is a medical problem.

Now the surgery does have an added bonus of improving ones appearance, which patients enjoy. It is an added benefit for the patient, and most are very appreciative.

In these cases [insurance covered], your surgeon is under no obligation to revise your surgery unless your vision is still significantly affected by additional droop or excess skin. And there are very strict criteria set forth by insurance companies that defines exactly what "visually significant" means. You should also be aware the compensation surgeons receive from insurance companies is a significant discount from cosmetic fees. And as such surgeons would lose money by doing "pro bono" surgery for cosmetic reasons!!

When this procedure is performed as cosmetic surgery, surgeons may sometimes offer revision surgery at a discounted rate to unsatisfied patients in which they feel revision is beneficial and reasonable. Again they are under no obligation to do so, since as surgeons we know that we cannot guarantee results, or patient satisfaction, and this is discussed in the consent forms of most cosmetic surgeons.

 

I hope this explanation helps.

 


Seattle Oculoplastic Surgeon
5.0 out of 5 stars 23 reviews

Question for your surgeon

+1

Final result of a blepharoplasty takes at least 3 months to appreciate and it is highly unusual for a surgeon to perform additional surgery especially for the reasons you state so quickly after your procedure. The goal of any cosmetic surgical procedure is improvement not perfection. If this procedure was covered by your insurance, it was performed for functional reasons not cosmetic and therefore, cosmetic reasons will not be used to determine need for a revision procedure. This question can only be answered by your surgeon.

Edwin Ishoo, MD
Brookline Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.