Will Medicare Cover My Eyelid Surgery?

• 28 October 2021
• MCC Marketing

Last updated on July 5, 2022

Are you noticing your eyelids drooping as you age? Do you find yourself looking older and less rested than you actually are due to dark bags under your eyes and droopy eyelids? Have you experienced drooping of the eyelids or vision problems due to an accident, deformity, or illness such as cancer? If any of these are true of you, it might be time to consider eyelid surgery at My Cosmetic Clinic. Keep reading to learn more about your Medicare options and the procedure itself.

Will Medicare Cover My Eyelid Surgery?

If performed for medical reasons, blepharoplasty or eyelid surgery may attract a Medicare rebate and private health insurance coverage.

Drooping Eyelids

Among the conditions covered by Medicare Benefits Schedule Upper Eyelid Surgery is ptotic (drooping) eyelid skin. Medicare will only cover your treatment if your upper eyelid skin droops significantly and impacts your field of vision. You may qualify for a Medicare rebate for Eyelid Surgery (Blepharoplasty) if the skin on your eyelid makes it difficult to see. For proof, you will need to undergo a visual field test from an opthalmologist.

Reconstruction

When the surgery is performed to reconstruct eyelid cancer defects, improve birth defects, accidents or malpositions of the eyelids such as entropion or ectropion, it is considered medical and will attract a Medicare contribution and private health insurance coverage.

Talk to Us!

We may be able to help you understand whether medically necessary eyelid surgery is right for you during your initial consultation. Medicare will only issue an item number if you can provide evidence that demonstrates the clinical need for eyelid surgery. Reports from optometrists and ophthalmologists will help.

About Eyelid Surgery

Blepharoplasty, also known as eyelid surgery, is a procedure designed to enhance the appearance of either the upper eyelids (upper blepharoplasty) or the lower eyelids (lower blepharoplasty). As a result of removing excess fat and muscle and tightening sagging skin, the eyes may be brightened and become more open and vision may be improved. Undereye bags can be eliminated in one step, which could help you feel happier, healthier, and years younger.

Benefits of Surgery

Eye enhancement without blepharoplasty is extremely difficult. Injectables may temporarily provide some improvement, but there are not very many injectables available on the market that can be used safely around the eyes because of the thin, delicate skin in that area. In addition, they can’t remove excess fat or muscle.

In contrast, blepharoplasty is both safe and a one-time treatment. You won’t have to undergo injections every two months just to maintain your look. And when you look the way you feel–bright and alert–your self-confidence may improve dramatically.

What Happens During Surgery?

The type of blepharoplasty you need will depend on the concerns you have.

Upper Blepharoplasty

People with upper eyelid concerns may benefit from upper blepharoplasty. This procedure involves the removal of excess fat, muscle, and skin from the upper eyelid area and may be able to reconstruct the area in the case of deformities or illness.

As the incisions heal, they will be hidden in your upper eyelid’s natural creases, so that no one will be able to see them. A procedure like this may be able to eliminate hooded eyes and the sagging of upper eyelids for up to 15 years.

Lower Blepharoplasty

The most common reason for lower blepharoplasty is to tighten loose skin and remove excess fat that causes bags beneath the eyes. You may appear tired and inattentive if you have undereye bags.

Undereye bags may be eliminated by lower blepharoplasty. The removal of excess fat will prevent you from having to worry about under-eye bags again since adults cannot make new fat cells.

Am I a Candidate?

If you want to improve the appearance of your upper or lower eyelids, you may qualify for this procedure. When deciding who qualifies for blepharoplasty, we look for people who are healthy enough to undergo general anesthesia, which keeps them asleep during the procedure. If you are required to take blood-thinning medications as a result of a heart condition, this procedure may not be right for you.

You may also not qualify for this procedure if your blood is naturally thin. Certain medical conditions affecting the eye region, such as those affecting the eyes and eyelids, may also exclude you from participation. Our initial evaluation will determine whether or not you are a candidate for this procedure based on your medical history and current health. We will then assess whether this procedure can help you achieve the goals you desire.

The Process

Our first consultation is a great opportunity for us to answer all of your questions about the entire treatment process, from preparation to recovery. It’s also important for us to make sure you are healthy and that this is the right procedure for caring for your medical and aesthetic needs. During this time, we can also help you understand whether Medicare is a good option for you.

Preparation

If you lead a generally healthy lifestyle, preparing for this procedure is not difficult. Pausing or avoiding the use of blood thinners and other supplements is one of the most important recommendations you must follow, and we’ll discuss with you exactly what you should avoid before your procedure. Before your procedure, you should avoid taking these drugs and supplements. Alcohol should also not be consumed 48 hours prior to your treatment.

In addition, you should take steps in the two weeks leading up to your procedure to reduce your risk of sunburn and other skin irritation. Furthermore, you should refrain from smoking in the two weeks before your procedure.

In the eight hours leading up to your procedure, you should not eat or drink anything if general anesthesia is administered rather than local anesthetic and sedation. Within eight hours of your procedure, you may drink water with any medications you must take. It is not necessary to fast before receiving IV sedation, however, you should consume only light foods and clear liquids.

On the Day

On the day of your procedure, you should have someone drive you to the office. If you have any last-minute questions about the procedure or recovery process, we will be happy to answer them.  Anesthesia will be administered to keep you comfortable throughout the procedure. Your eyelids will be cleaned, and small, discrete incisions will be made that will remain hidden while they heal. The excess fat and muscle tissue will be removed after the incisions have been made. The excess skin will be removed afterwards.

After that, a suture will be used to close the incisions and tighten sagging skin. Last but not least, we will apply a dressing to keep your skin protected while it heals. Your alertness will be monitored as the anesthesia wears off. After that, you can go home. There is no need to stay in a hospital for observation after a blepharoplasty. It is performed as an outpatient procedure. Recovery instructions will be given to you before you leave.

Recovery

If you follow the post-operative recovery guidelines, your skin will be sufficiently healed for the removal of the protective dressing after one or two days. Your recovery will be accelerated significantly if you apply a prescription healing ointment daily to your incision sites. You’ll likely spend about 96 hours at home recovering.

Additionally, you may take analgesics during your recovery as long as they do not thin your blood. Usually, people need to take off about a week from work, but you should avoid strenuous exercise for at least a month.

Caring for Skin

You should also avoid unprotected sun exposure during your recovery period. Your recovery may be slowed down by ultraviolet (UVC) rays, so avoid the sun and wear sunscreen when you must go out.

Your eyelids should be completely healed about four to six weeks after your procedure. Your final results should last approximately 10 to 15 years at this point.

Learn More and Get Started

Whether you’re suffering from a deformity, the natural effects of aging, or recovering from an accident or illness, sagging eyelids and bags don’t have to be something you just live with. Surgery may be able to correct these issues and give you a younger, more well-rested look. If you want to learn more, visit us at My Cosmetic Clinic today to learn more and to schedule your initial consultation. We can’t wait to help!