Time, heredity and our environment can cause the upper eyelids to become heavy and droop. If the sagging of the upper eyelids becomes too severe, it can limit your peripheral vision and impact your ability to drive or live your life. In this case, a surgical procedure called a blepharoplasty, or eyelid lift, can improve your vision and quality of life. As an added bonus, a functional blepharoplasty can also give you a more youthful look, as sagging eyelids are a sign of age.
An upper eye lift should not be confused with an upper eyelid ptsosis procedure, which raises the position of the upper eyelid margin by tightening the muscle that elevates it. A blepharoplasty may elevate the upper eyelid margin a bit if there is a great deal of excess skin weighing down the eyelid, however.
When is Functional Blepharoplasty Required?
A functional blepharoplasty, unlike cosmetic blepharoplasty, is performed for medical purposes. In most cases, this procedure is performed to remove excess skin and fat from the upper eyelid when it droops far enough to impair vision during driving and other daily tasks. Some people also require blepharoplasty when they have difficulty wearing contact lenses or glasses due to drooping eyelids.
There are other medical conditions that may require a functional blepharoplasty. This includes irritation from folds of the eyelid rubbing together, and discomfort from overusing muscles that strain to lift the eyelids. Some people find their eyelids droop to such an extreme that they have difficulty holding their eyes open.
How is a Functional Blepharoplasty Performed?
If your vision is impaired by your upper eyelids, the surgeon will make small incisions along the natural creases of your eyelids. Excess fat, skin and muscle are removed, then skin is repositioned and then sutures are placed. In some cases, a laser is used to make the incisions to decrease bleeding and speed up the procedure. An upper eyelid lift is usually an outpatient procedure with “twilight” sedation given intravenously.
In some cases, eyebrow surgery is also performed, as eyebrow position can contribute to heavy eyelids. Simply performing the eyelid lift can cause the brow to pull down further.
Blepharoplasty is a fairly straightforward procedure with minimal recovery time. Blepharoplasty recovery may take up to two weeks, which is about how long it takes for self-dissolving stitches to disappear. Most patients require no more than over-the-counter Tylenol for discomfort after surgery. Swelling and bruising usually resolves within two weeks, and most patients return to work in seven days or less.
To ease recovery, you may want to use a cold compress on your eyelids for the first two days and to avoid too much bending or lifting.
When is Blepharoplasty Covered by Insurance?
In some cases, insurance will cover the cost for an eyelid lift. If you have significant interference with your vision or obstruction of your outer visual fields, your insurance company or Medicare will usually require a visual field test to document at least 30% loss of upper field of vision. Your insurance may also cover the cost if you have trouble reading due to field of vision loss, or you are looking through your eyelashes and can see the skin of your upper eyelid.