One of the most commons questions my patients ask is, “does insurance cover Blepharoplasty, (also known as an eyelid lift)?” or “will my insurance cover eyelid surgery?”
This a great question. Most insurance companies have specific guidelines regarding criteria for covering eyelid surgery. While there may be subtle differences between different carriers, most insurance companies base their criteria off Medicare guidelines.
In general, insurance companies will cover Blepharoplasty or Ptosis repair if the eyelids cause a “visually significant” obstruction of the upper visual field that “affects activities of daily living”. To put it another way, if the upper lids block enough of your vision to significantly affect your life, then blepharoplasty or ptosis repair is considered medically necessary and may be covered by insurance.
So what are the criteria that insurance companies use to determine if blepharoplasty or upper eyelid surgery is “visually significant”, and therefore will be covered? There are 3 pieces of information they need:
1) Physician notes. These notes must clearly document the position of the lids, a decreased visual field, and a patient complaint about the upper lids interfering with certain activities (driving, reading, etc). The lid position should be measured using standard oculoplastic measurement techniques showing the lid or excess skin comes within less than 2 millimeters of the pupil (also called an MDR1 less than 2mm).
2) External ophthalmic photography. Basically these are high resolution photos of the eyelids and eyes. For criteria to be met, the eyelids or extra eyelid skin must clearly been seen to fall within less than 2 millimeters of the center of the pupil. Clear frontal and side photos are required.
3) Visual Fields. A visual field test is a noninvasive way to evaluate peripheral vision. This test is usually performed at an ophthalmology office. The field of vision is tested both with the eyelids in their natural position and with them held up (usually with tape). The difference between the taped and untapped visual field determines whether or not insurance will cover upper eyelid surgery. The visual field must improve by a certain percentage or certain number of degrees depending on the insurance carrier.
If the answer is yes, then the next step is to submit all notes and testing to the insurance company. The carrier will then either “pre-authorize” or deny the claim. A pre-authorization means that the insurance company agrees that eyelid surgery is medically necessary and they plan on covering the blepharoplasty or ptosis repair. Although a pre-authorization is very reassuring, they are not a 100% guarantee of coverage. Occasionally insurance carriers will do a second review of the case after the surgery has been performed.
Medicare works a bit differently. Medicare does not pre-authorize anything (any procedure- not just eyelid surgery). Medicare does, however, have clearly defined criteria that most oculoplastic surgeons know in detail. Based on the exam and testing, it can be determined if Medicare would typically cover a patient’s eyelid surgery. While most oculoplastic surgeons are correct in their coverage assessment, since Medicare will not pre-authorize surgery, a form called an “ABN” is usually completed and signed by the patient. The ABN typically states that while the surgeon believes Medicare will cover the Blepharoplasty or ptosis repair, the patient is responsible for the payment if the claim is denied. Again, most oculoplastic surgeons will be able to give a fairly accurate assessment of whether Medicare or an insurance company will cover blepharoplasty or eyelid surgery.
When the patient wishes to have a procedure even though there is no insurance coverage, an eyelid lift is among the most affordable plastic surgery options. It can usually be performed in the office, without the additional cost of general anesthesia or outpatient surgery assistance. Hopefully this gives some insight about the process and criteria for insurance coverage. Please contact us at (405) 418-5400 if you have questions or would like further information about Blepharoplasty.
The area on your face around your eyes is very important in communication. After all, most people look at a person’s eyes first to help them understand what the person is feeling or trying to communicate. Saggy, lined foreheads can give the wrong impression to those encountering you; they can feel as if you’re mad, sad, or just really tired. But a brow lift with Dr. Jones can remedy this problem.
Who can use a brow lift?
A brow lift, also called a forehead lift, is necessary because as we age, the forehead and eyebrow tissues descend and hood along the upper ridge of the eye. A brow lift is a great procedure for patients who have sagging or low eyebrows, and if they have horizontal creases across their forehead. It’s also a good answer for people with the 11s, those vertical frown lines between the eyebrows. If you have deep frown lines on the forehead, a brow lift is really the only way to get rid of them.
Dr. Jones employs different techniques in his brow lifts, depending on the individual situation of the patient.
Coronal brow lift — This is the “traditional” brow lift. As incision is made across the top of the scalp running down adjacent to the ears. It is made very close to the hairline to conceal it as much as possible. Underlying tissue is repositioned as possible and excess skin is trimmed.
Endoscopic brow lift — Dr. Jones makes a series of three to five tiny incisions along the forehead, rather than one continuous incision. An endoscope is then inserted into one of the incisions to allow Dr. Jones to see under the skin. This method doesn’t allow for results as dramatic as a traditional lift, as the entire forehead skin is not lifted away and repositioned.
Transpalpebral brow lift — In this method, the incision is made in the upper eyelid and is used to correct frown lines between the eyebrows or at the top of the nose.
Direct and mid-forehead lift — Dr. Jones rarely uses this method as it leaves more visible incision scarring afterwards.
Want to look younger by losing those sagging brows? Call Dr. Jones at 405.418.5400 and let’s talk about a brow lift.
As we age, our brows sag and droop. Maybe not to the degree of Deputy Dog from the cartoons, but they droop. The forehead and eyebrow tissues descend and hood along the upper ridge of the eye. This results in a perpetually mad or tired look. Who wants that? Everyone will think you’re a curmudgeon!
But a brow lift with Dr. Jones can bring back your younger days.
A brow lift will benefit patients with sagging or low eyebrows and those with horizontal creases on the forehead. And the 11’s? Yep, a brow lift turns them into the zeroes!
Want to see if you could use a brow lift? Take your palms of your hands and place them above and just outside of your eyes. Now pull up and a little outward. That’s basically what a brow lift can do. The procedure can take years off your face.
A brow lift with Dr. Jones is done on an outpatient basis. The procedure usually takes from two to three hours. There are various methods available depending on your needs.
Coronal brow lift — This is a traditional brow lift. An incision is made across the scalp, running from above the ear up and around the forehead, ending above the other ear. The incision is made in the hairline to hide it. The skin is pulled away and underlying muscles may be repositioned and tightened. Then, excess skin is trimmed.
Endoscopic brow lift — If the patient doesn’t need as much trimming, an endoscopic brow lift could suffice. A series of very small incisions are made and an endoscope is inserted into one. This provides Dr. Jones with a view of the area, without the need for the full incision of a coronal lift. He can use the endoscope to reposition muscles.
Transpalpebral brow lift — This is a limited procedure, making an incision on the upper eyelid to correct frown lines between the eyebrows or at the top of the nose.
Direct and mid-forehead lift — This technique creates more incisions, so is used only as a last resort.
Interested in getting rid of that perpetually mad look? Call Dr. Jones at 405.418.5400 and let’s talk about a brow lift.
Brow lifts are sort of the forgotten cosmetic surgery. Everyone thinks of facelifts, nose jobs, eyelid surgery, breast augmentation or lifts, tummy tucks, and liposuction. Brow lift… not so much.
But when people ask you if you’re tired or angry all the time, it could be time to consider a brow lift.
Aging causes our tissues on the forehead and the eyebrows to sag and descend. This winds up creating a hood along the upper ridge of the eye, creating the tired or angry expression. A brow lift brings these tissues back up.
Types of brow lifts
Dr. Jones uses different brow lift techniques depending on the individual circumstances of each patient.
Coronal brow lift — This is the traditional brow lift. An incision is made across the top of the scalp from ear to ear, very close to the hairline. The underlying muscles are tightened and excess skin removed, and the eyebrows are repositioned.
Endoscopic brow lift — This uses small incisions along the forehead rather than one continuous one. An endoscope is used to see the tissues and muscle and to repair and trim where needed.
Transpalpebral brow lift — An incision is made on the upper to correct frown lines between the eyebrows or on the top of the nose.
Direct and Mid-Forehead brow lift — This technique, while the most direct, creates the most visible scarring, so is very rarely employed.
Tired of looking tired? Call Dr. Jones at 405.418.5400and let’s talk about a brow lift.
It stinks getting old. Just ask your brows. Gravity, aging, and sun damage can make the skin on your brows sag and droop. This, of course, can make you look perpetually tired, and then become the recipient of the perpetual inquiries as to your energy level!
But you can regain your younger look with a brow lift.
Brow lifts are sometimes called forehead lifts. The surgical procedure aims to eliminate wrinkles and creases in the forehead area and the area around the brows. People with sagging skin over their upper eyelids can really benefit from a brow lift.
How do they do a brow lift?
Most brow lifts now use the endoscopic approach. Multiple small incisions are made behind the patient’s hariline. Then an endoscope (a tube with a tiny camera attached to its tip) is inserted into the holes. Through the camera, Dr. Jones can see the area he is working on, helping him better manipulate the tissue. Excess tissue is removed and, where needed, muscle is repositioned.
Some brow lifts still use the ear-to-ear incision technique, but Dr. Jones prefers the endoscopic method because it is less invasive and creates less scarring.
If you’re tired of questions about being tired, maybe it’s time for a brow lift with Dr. Jones. Give us a call and let’s talk about your options.
Many patients here at our practice would often ask about their facial surgical options when it comes to reducing the appearance of fine lines and wrinkles in the upper third of the face. Due to the soaring popularity of the eyelid lift (also known as blepharoplasty) for the past year, they would often assume that they need the same type of cosmetic surgery, too. Little did they know that a brow lift is actually the procedure they’re looking for – an endoscopic brow lift to be specific.
What is an endoscopic brow lift?
By and large, an endoscopic brow lift is a brow lift technique that aims to restore sagging brows to its natural position in the most minimally invasive way possible. This technique is quite different from the traditional brow lift (also known as the classic or coronal brow lift) in which a long incision is made across the forehead or either in one of the creases of the forehead or around the hairline. Both traditional and endoscopic brow lift techniques have the same aesthetic goals but the latter is often preferred because it only involves minimal downtime resulting to less obvious scarring.
Who should have an endoscopic brow lift technique?
Aside from being generally healthy and having realistic expectations of plastic surgery, you are an ideal candidate of the endoscopic brow lift technique if:
you have deep vertical lines (frown lines) in the forehead
you have horizontal creases running across the forehead
you have drooping lateral brows, making you appear tired or angry
How is an endoscopic brow lift done?
Your endoscopic brow lift will typically begin with 3 to 5 tiny incisions, each one is about less than an inch in length. Consequently, Dr. Jones will insert an endoscope through one of the incisions to acquire a clearer picture of the underlying tissue. On the other hand, another instrument will be inserted to a different incision to lift the underlying muscles and tissues.
What are the risks associated with the endoscopic brow lift technique?
Of all the brow lift techniques, the endoscopic approach is the most safest and has lowered risks of complications than other techniques. Potential risks from the procedure include possible nerve damage, infection, bleeding, and infection.
What should I expect while recovering from a brow lift?
You can expect to take at least a week off from work while recovering from a brow lift. Bruising, swelling, and temporary numbness may be present but will eventually disappear within 7 to 10 days following surgery.
Your Endoscopic Brow Lift Plan by Dr. Timothy Jones
Dr. Timothy Jones creates a unique treatment plan that best suites each individual patient’s needs and desires. In many cases Dr. Jones is able to employ the use of an endoscopic brow lift, which is a much less invasive version of the conventional brow lift and requires smaller incisions. Having smaller incisions also means a quicker recovery time.
See the results now in our Brow Lift Gallery! If you would like to learn more about if a brow lift is right for you, we invite you to call 405.418.5400or fill out this contact form to schedule an appointment. We look forward to your visit!
Brow lifts have always been a popular procedure. This helps to remove lines on the forehead and sometimes around the eyes, areas which people often consider a key point that makes them look older. Because they are so popular, this procedure has seen very distinct improvements in how it is performed which can only come with years of expertise. While many used to complain that a brow lift would leave their face looking out of sync, the transition from a lined forehead to a wrinkle-free appearance is now all but seamless once the procedure is completed.
Cutting Down on Trauma
One of the difficult things about having a brow lift done was also the recovery time. The face is a very sensitive area with a lot of blood vessels and nerves which could be damaged or disrupted during surgery. A major procedure like a brow lift which required individuals to undergo an incision from ear to ear would often be very uncomfortable and take a long time to heal, which left many feeling frustrated and sore for weeks before they could fully enjoy the results of their procedure. Doctors have been working to improve this problem to help individuals who elect to undergo this surgery manage it that much more easily.
The key way that brow lifts have been improved is by reducing the size of the incision necessary to complete the procedure. Instead of a large cut across the top of the face, small incisions are now used to contort the brow according to the natural shape of an individual’s face. Not only does this cause the body less trauma, but it helps to make the results look more natural once the body starts to heal, giving individuals a look that is refreshed instead of permanently alarmed.
It looks like the appearance of wrinkles do more than just make you look older. In 2012, a study whose results were published in the Journal of Experimental Social Psychology revealed that the presence of facial lines, creases and wrinkles can also get in the way of how people perceived your emotions.
By and large, the researchers of the study instructed 65 college-aged volunteers to rate the photographs of 3 women who were between 19 and 21 years old and another batch of 3 women who were between 76 and 93 years old. Earlier in the study, the researchers also instructed the women to convey basic facial expressions such as happiness, sadness, anger, and being neutral.
The researchers found out that it was easier for the young volunteers to correctly identify the facial expressions of the 3 women who were between 19 and 21 years old. On the other hand, majority of the volunteers had a hard time judging the emotions of the older women in the photographs.
“In the case of the older expresser, the anger is seen as mixed with other emotions,” Dr. Ursula Hess, a professor of psychology at Humboldt-University in Berlin and the study’s lead author shared. “Clearly it makes a difference whether you think someone is just angry or someone is both angry and sad.”
Cosmetic Procedures That Can Help Reduce Frown Lines
Before you make an appointment for a face lift consultation here at our Edmond facial cosmetic surgery practice, you might want to reconsider your options. Many people assume that a face lift will correct all kinds of facial aging concerns such as the appearance of frown lines. However, a face lift procedure is actually ideal in addressing aging in the middle and lower third of the face such as sunken cheeks and a sagging jawline.
If you wish to reduce the appearance of frown lines that can ultimately make you look upset, sad, or angry to others (when in fact you aren’t), the following cosmetic procedures may be more appropriate:
Brow Lift – A brow lift will benefit men and women with sagging brows and upper eyelids. In this procedure, worry lines and creases will be also significantly reduced.
Upper Eyelid Surgery – Sagging skin and excess fat around the upper eyelids can be improved with an upper eyelid surgery. Apart from its cosmetic purpose, the procedure can also help improve obscured vision resulting from too much puffiness in the upper eyelid area.
Non surgical treatments such as Botox, fillers and laser treatmentscan also be done alone or in conjunction with the aforementioned surgical procedures, depending on the severity of the wrinkles and excess, loose skin in the upper third of the face.
Planning for Your Facial Cosmetic Surgery with Dr. Jones During your initial consultation with Dr. Jones, a through discussion and assessment of your cosmetic goals and aesthetic preferences will take place. Moreover, a physical assessment will follow, particularly in the anatomical structure of your eye and face such as bone structure, skin tone and texture, and muscle dynamics.