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Functional Blepharoplasty


What is Functional Blepharoplasty?

Blepharoplasty is a type of plastic surgery that an Ophthalmologist can perform on the upper or lower eyelids to remove excess skin and fat from around the eyes. A Functional Blepharoplasty is performed specifically when the excessive drooping of skin on the upper eyelids block the vision in the upper half of the visual field. Unlike Cosmetic Blepharoplasty, Functional Blepharoplasty is consider a medical condition and it typically covered by Medicare and other health insurance plans.

Why is Functional Blepharoplasty performed?
This procedure is done to improve visual function. Excessive upper eyelid tissue can block the upper part of the visual field. This can be determined by lifting the upper lids with your fingers to see if the upper visual field improves or vision brightens. A formal visual field test is typically obtained in this situation in addition to “before” photos to document the obstruction. Functional Blepharoplasty is one of the most common plastic surgery operations performed by ophthalmologists.

Why is it important to consult an Ophthalmologist when considering Functional Blepharoplasty?

Because Blepharoplasty can affect the function and lubrication of the eye, a consultation with an Ophthalmologist is important. Although other surgeons may perform Blepharoplasty, an Ophthalmologist is the only surgeon trained specifically to treat the eye. Therefore, he or she is uniquely qualified to help you decide whether you should consider this surgery. In addition, the testing required to qualify for Medicare or insurance coverage is typically performed by an ophthalmologist. 

How is eyelid surgery performed?

After the amount of skin and fat to be removed has been determined, upper incision lines are marked along natural skin creases. Incision lines generally extend into the “crow’s feet” or “smile lines” at the outer edge of the eye, so that once healed, the incision lines are less visible. The excess skin and fat are removed, and the incisions are sutured closed. The procedure is typically performed with local anesthesia and IV sedation. 

Can I Get My Lower Eyelids Done?

Unfortunately, if the lower eyelids sag, they will never block your vision. Therefore, Medicare and other insurance companies will never cover Lower Eyelid Blepharoplasty. There are some cases where the lower eyelid is sagging so much that they no longer make contact with the eye. This can lead to severe dry eye and infections which can lead to loss of vision or loss of the eye. This condition is called ectropion and required a different procedure to correct it. This is covered as a medical procedure.

What results can I expect?

Generally results are successful. However, surgical outcome will depend on the extent of corrective work, the skin structure and healing process, hereditary factors, age and other physical characteristics. As with any surgical procedure, an element of risk exists. Hemorrhage, infection, or even blindness, though rare, may occur. If you are a cigarette smoker, we encourage you to discontinue smoking as this could cause poor wound healing and a worse cosmetic result. 

Real Results from the SA Eye Institute

blepharoplasty san antonio

Before: Upper Eyelids with Dermatochalasis Blocking the Upper Half of the Visual Field on Formal Testing

blepharoplasty san antonio

After: Upper Eyelids now in a More Natural Position and No Longer Blocking the Upper Half of Field of View