Lid Abnormality

Blepharoplasty

Blepharoplasty

Blepharoplasty is a surgery that repairs droopy eyelids and may involve removing excess skin, muscle and fat. As you age, your eyelids stretch, and the muscles supporting them weaken. 

Upper blepharoplasty surgery uses incisions to allow for removal of skin and fat. A thin stitch is then used to bring the skin together to allow for a creation of an eyelid crease. 

Lower eyelid surgery can involve skin incisions directly below the lash line or an incision on the inside of the eyelid. 

Why is eyelid surgery performed? 

Excess skin and fat can create a heavy looking eyelid, aged appearance, puffiness, and sometimes block the upper field of vision. Upper blepharoplasty can improve the field of vision. 

How much does eyelid surgery cost? Does insurance cover the cost of blepharoplasty?

 Insurance carriers will only cover the cost of upper eyelid surgery if the patient has obstruction of their visual field. This must be documented with formal visual field testing and photographs. Some insurance carriers require submission of the visual fields and photographs before approving the blepharoplasty as a medically indicated procedure. 

Entropion
Ectropion
PTOSIS
Dermatochalasis

Dermatochalasis refers to redundancy of eyelid skin and is often associated with orbital fat protrusion or prolapse. Significant dermatochalasis of the upper lids leads to complaints of a heavy feeling around the eyes, brow ache, eyelashes in the visual axis, and, eventually, reduction in the superior visual field

Indications for upper eyelid blepharoplasty

Indications for upper eyelid blepharoplasty include redundant and lax skin and fat herniation that result in either functional visual symptoms. Dermatitis of the redundant skin can also be an indication for surgery.

Risk Factors

  • Aging

  • Inflammatory diseases affecting the eyelids

  • Chronic lid swelling/edema associated with systemic disease or allergy

  • Family history

Diagnosis

History

Patients often report drooping, sagging, tired appearing eyelids that interfere with various activities of daily living. In severe cases, patients may have to manually lift the skin upward to improve their visual field. A complete medical and ophthalmic history should be obtained that includes:

  • Impact of upper eyelid changes on activities of daily living

  • Previous ocular conditions and surgeries

  • Systemic disease which will influence the outcome of the surgery such as rheumatologic conditions, collagen vascular diseases and diabetes

  • Prior cosmetic procedures

  • Dry eye symptoms and treatments

  • Complete list of medications including blood thinners and herbal supplements

Physical examination

Eyelid examination

  • Quality, quantity and relative symmetry of redundant skin

  • Eyelid crease height and symmetry

  • Fat pad herniation

  • Evaluation for presence of concurrent ptosis

  • Assessment of brow position

Ocular vital signs Visual acuity, pupillary examination, extraocular motility, intraocular pressure, corneal exam, and tear evaluation.

Diagnostic procedures

Visual field testing with the eyelids untaped and taped can be used to quantify the degrees of visual field obstruction present in patients with severe dermatochalasis and preaponeurotic fat herniation.

Location

Find Us On a Map

Office Hours

Monday

7:30 am - 4:00 pm

Tuesday

7:30 am - 4:30 pm

Wednesday

7:30 am - 4:30 pm

Thursday

7:30 am - 4:30 pm

Friday

7:30 am - 3:00 pm

Saturday

Closed

Sunday

Closed

Monday
7:30 am - 4:00 pm
Tuesday
7:30 am - 4:30 pm
Wednesday
7:30 am - 4:30 pm
Thursday
7:30 am - 4:30 pm
Friday
7:30 am - 3:00 pm
Saturday
Closed
Sunday
Closed