I had the procedure done and covered by my insurance company approximately 10 years ago. One eyelid is significantly "drooping" although I know that this will have to be documented by a visual field, is there usually any leniency if this surgery has been done before? Thank you.
Blepharoplasty Surgery REPEAT SURGERY?
Doctor Answers 5
Blepharoplasty Surgery REPEAT SURGERY? I had the procedure done approximately 10 years ago.
If you had an Upper Eyelid Surgery (Blepharoplasty) done 10 years ago, this should not need to be repeated. The upper eyelid droop is more likely due to true upper eyelid ptosis or because the eyebrows have dropped in position. Either, of these scenarios, would require something other than another upper Blepharoplasty. You should have a few consultations with experienced Plastic and Cosmetic Surgeons to make the correct diagnosis and recommendations.
Upper blepharoplasty and medical necessity
Upper lid blepharoplasty is occasionally paid for by insurance when it is a medical necessity. A significant amount of visual obstruction must be present in order for the surgery to be qualified under medical necessity. Each insurance company has different criteria. It is immaterial if eyelid surgery has been done in the past.
Causes of droopy/heavy upper eyelids
There are two separate problems occur in the upper eyelids in the aging process that contribute to upper eyelid heaviness or droopy upper eyelid. One is that the skin looses elasticity and "stretches". For this, upper blepharplasty is performed where extra loose skin is removed. The second thing is that the eyelid drops with time because the muscle/tendon responsible for lifting the upper eyelid relaxes. This is called ptosis. For this, the muscle has to be tightened, thereby lifting the upper eyelids and opening the eyes more (ptosis surgery). Often, upper blepharoplasty is performed in middle-age but the eyelid continues to drop after that (ptosis) and the same person then needs ptosis surgery later in life. See an oculoplastic surgeon for evaluation.
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Each evaluation of your visual fields are done independently, so your having had surgery done 10 years ago would not affect this.
It is unlikely that you would have had visual field changes due to excess eyelid skin [blepharoplasty addresses this], but rather that the eyelid itself is actually droopy [eyelid ptosis]. Visual fields and photos would be required to document that the degree of droop is in fact "visually significant". Insurance companies have determined a threshold of severity before covering surgery.
An evaluation by an Oculoplastics surgeon is your best route of action. You can find one close to you on asoprs dot org.
Recurrence of Dermatochalasis at 10 Years
If you have a dermatochalasis recurrence, you will likely need visual fields done. Usually, the insurance company will avoid paying for this.
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.