i've seen a couple of eye PS in NC and have been told that these are two separate surgeries with separate costs. Additionally I was told there has to be medical reason for the lift not just cosmetic. I'm wondering if in California where PS is commonplace, if these surgeries are one in the same and/or if medical reason is also necessary. If they are one in the same would my paperwork just state upper blepharoplasty or would it have to be noted as two separate surgeries?
Is Ptosis Surgery Part of a Blepharoplasty or is It a Separate Procedure?
Doctor Answers 22
Ptosis repair and Blepharoplasty are seperate procedures. Ptosis repair raises the eyelid height by tightening the muscles that elevate the eyelid. Blepharoplasty involves removing excess skin and/or fat. Insurance can cover these procedures if medically indicated. Often the ptosis repair is covered and the blepharoplasty is cosmetic. This will depend on your eyelid examination. If, as you stated, the paperwork says blepharoplasty is covered, then the ptosis repair would not be covered since it is a seperate procedure.
Ptosis surgery is in fact different from a blepharoplasty. In ptosis surgery the eyelid muscle is weak and needs to be lifted and tightened. In a blepharoplasty there is extra skin that needs to be removed. Two different procedures in the same location. Patients often think that the eyelid is lifted by removing skin which is not true. The eyelid is lifted by tightening the muscle under the skin. Hope that helps.
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.
Web reference: http://www.kassmd.com
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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.
These are two different things, that happen to be in the same area.
Blepharoplasty is the removal of the eyelid skin and/or fat. It is typically a cosmetic procedure.
Ptosis repair is one of a variety of procedures to re-adjust the level of your eyelid, often by shortening and suturing the lid-opening structures. It is typically a functional (insurance) procedure.
Good luck with your surgery.
As noted by the responding surgeons... Ptosis repair is usually considered medically necessary surgery and may be convered by insurance. Blepharoplasty surgery may be covered if severe restriction in visual fields is noted. Predetermination of benefits may help to answer your questions but does not guarantee that your procedures will be paid by the insurance company
Ptosis, also known as blepharoptosis, is a drooping of the eyelid. Correction of this condition usually requires surgery on the muscles and tendon located within the eyelid.
Blepharoplasty is a term used to describe surgery for removal of excess skin and fat from the eyelid. In most cases the eyelid height is unchanged following surgery.
Although a single incision on the outside of the eyelid can be used to perform both surgeries, ptosis repair and blepharoplasty are separate and distinct procedures.
In some cases insurance will cover these procedures if deemed medically necessary because of visual field loss.
Blepharoplasty involves removing skin, fat, and or muscle and does not include eyelid ptosis repair. Ptosis repair is done to tighten the upper eyelid muscle and raise a droopy eyelid. In some cases, this can improve your vision in the upper visual fields, and if so, your insurance may help cover the costs of the procedure, esepecially if your droopy eyelids cover your pupil.
If you do the bleph and the ptosis at the same time, your costs would be less than if you did them at two separate times, since it is easier to do the second procedure once you are already prepped, draped, and anesthetized for surgery.
On the operative report, two procedures will be listed.
Blepharoptosis repair is considered distinctly separate from blepharoplasty. The former is primarily a muscle and tendon operation whereas the second is a skin and fat procedure
Web reference: http://www.bodysculptor.com/facial-surgery-chicago/eyelid-lift/
Ptosis describes a condition whereby the eyelid "window-shades" the pupil, which the functions as the light aperture for the eye. The causes can be congenital, or more commonly, age related. The levator aponeurosis, which effectively lifts the eyelid can become stretched, attenuated, or undergo fatty degeneration over time. This leads to a less optimal baseline eyelid position, obstructing the superior visual field. Ptosis is commonly seen in conjunction with eyelid skin excess (dermatochalasis), which can also cause a visual field impairment. Both procedures (Blepharoplasty and Levator Advancement) can be performed during the same procedure.
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.
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