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.
Valentine’s Day is a time when significant others get together to celebrate the love they have for one another. After the Christmas holiday gift exchange, a person may not know what to get his or her sweetheart. You can do the cliche thing and get flowers, but it is nicer to get something very personal with great intent. This is where a plastic surgery procedure can make the perfect gift. The plastic surgery gift can be for something small such as a lip injection to create fuller lips, or Botox to remove those unwanted wrinkles. A gift certificate can also be purchased for something bigger, such as facial makeover.
“I find that husbands really like to make their wives feel special on Valentine’s day and the gift of plastic surgery is a great way to do that,” says Dr. Tim Jones, a facial plastic surgery specialist in Oklahoma City. While some men may be hesitate to give there wife a gift that indicates a change in aesthetics, the overwhelming majority would be thrilled with the idea.
Most couples that communicate well have usually spoken about it at some point in the past. Valentine’s Day is a great time to bring it up again in a gentle fashion. If she has expressed interest in the past, she should be really excited about the prospect of a little enhancing. If there has been no discussion in the past, then the topic of plastic surgery can always be brought up by talking about a celebrity to judge your significant other’s reaction. If he or she seems open to plastic surgery, then the door is open to a nice gift.
“Occasionally we’ll have couples come in together for a consultation,” says Dr. Jones. “it’s a great opportunity for us to answer questions for both spouses and to talk about their objectives. It makes the conversation so easy, and it’s often interesting to hear what each spouse has to say about their own flaws. They’ll tell me that one started talking about how much they wished for rhinoplasty and they other mentioned that they always hated their ears. They don’t always choose to both have surgery, but sometimes one will choose surgery and the other will choose just a bit of Botox to erase a few lines.”
If a cosmetic procedure seems like a nice surprise, then a gift certificate might be the perfect gift — packaged in a beautiful heart shaped box of candy. The recipient will still need to have a consultation with Dr. Jones to determine candidacy, but we have an array of options to make sure your gift is absolute perfection! Happy V-Day lovebirds!
Smoking has always been linked to a wide variety of health issues, ranging from various types of cancer to heart conditions to breathing difficulties. In addition, it has also been associated with premature deliveries and low birth weight babies. At our facial cosmetic surgery practice, we encourage our patients to quit the habit weeks or months before their surgery for the following reasons:
Delayed Healing and Increased Risk of Complications Post-Surgery
Nicotine in cigarettes constricts the blood vessels, which in turn reduces the blood supply to body tissues. Once blood supply is reduced, the surgical site heals much more slowly. That delayed healing also translates into an increased risk of post-procedure complications and prolonged hospital stays.
Smoking Only Negates the Positive Effects of Facial Cosmetic Surgery
Certain chemicals in cigarette smoke significantly affect skin elasticity, leading to the appearance of fine line and wrinkles. If you don’t quit the habit shortly before your surgery, there’s a good chance you’re your desired outcomes from surgery won’t be fully achieved.
Let us help you quit smoking before your facial cosmetic surgery! Our team would love to help you out and answer your questions. Call 405.418.5400to schedule an appointment. We look forward to your visit!
There’s nothing more revealing about your real age than the eyes and the area surrounding it. Puffiness, discolored skin, and the appearance of crow’s feet are just some of the common issues we encounter among male and female patients seeking eye rejuvenation treatments here at our practice. By and large, Dr. Jones’ goal in each eye rejuvenation treatment is to maintain the natural shape and appearance of your eyes and the surrounding areas as much as possible.
The following are the signs of aging in the eyes and upper third of the face that men and women typically present themselves with here at our practice:
Brown spots and skin discoloration – This is primarily caused by prolonged sun exposure and is very common just below the eyes and above the cheekbones. You can use skin lightening creams to help lighten the area.
Wrinkling in the forehead, crow’s feet (lines that form around the eyes), and the 11s (vertical lines that form between the brows) – These are actually lines and wrinkles formed by repeated contractions of the muscles underneath the skin. Injectables such as Botox and Dysport are ideal for these concerns as they block the release of the chemical acetylcholine which in turn prevents the muscle from contracting.
Fine lines – Their appearance can be reduced through chemical peels or creams that contain alpha hydroxy acids.
Bags under the eyes – As the muscles in the lower eyelids weaken due to aging and gravity, extra fat accumulates resulting to the appearance of eye bags. A lower eyelid surgery may be done to reduce their appearance.
Excess, sagging skin – Upper eyelid surgery can help trim the excess skin and consequently remove excess fat if it’s present. Incisions in this type of eyelid surgery is typically tiny and imperceptible.
Under eye grooves – These grooves may appear as dark shadows in the under eye area. You can choose to either have fillers to reduce the appearance of grooves or have lower eyelid surgery to have fat from the surrounding areas transferred to the grooves.
Get in touch with us today to learn more about your cosmetic options to reducing the aforementioned signs of aging in the upper third of the face. Call 405.418.5400or fill out this contact form to schedule an appointment for your rhinoplasty consultation. We look forward to your visit!
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.
One might feel young on the inside but your face will eventually give your real age away. We have encountered patients who present themselves with various facial aging concerns here at our Edmond facial cosmetic surgery practice. Every so often, a thorough assessment and evaluation of their lifestyle habits and family history is done before we recommend the appropriate cosmetic solution for their facial aging woes.
Generally, the following are the most common signs of facial aging that we have observed here at our practice:
1. Crow’s feet – The appearance of fine lines and creases on the outermost corners of the eyes is on top of the list. By and large, the appearance of crow’s feet is a result of constant contractions by the underlying muscles around the eye area such as when you’re squinting and smiling. Botox is the most effective way to reduce crow’s feet as it blocks the release of acetylcholine which triggers muscle contractions.
2. Sagging eyebrows – The brows will start to sag and appear wrinkled as the collagen supply in the area dwindles as you age. A brow lift can help reduce significant amount of sagging in the brows.
3. Loose, excess skin in the upper and/or lower eyelids – In addition to this, wrinkles may also appear in or around the area. The more the eyelids sag, the more one will most likely to appear older. Blepharoplasty or an eyelid surgery can address this common concern.
4. Nasolabial folds – They are also known as the facial parentheses or those lines that traverse from the sides of your nose to the corners of your mouth. They may appear temporarily at first when making an expression but will eventually stick permanently as you get older. If you wish to go the surgical route, a face lift may work for this concern while fillers such as Restylane and Juvederm are recommended if you wish to try something minimally invasive at first.
5. Sagging Jowls – A combination of aging and gravity will almost always result to disintegration of the skin and fat layers in the lower third of the face. Sagging skin will consequently gather in the chin and neck areas resulting to the appearance of jowls. A face lift or a neck lift will work best for this concern. Jowls that are still minimal or moderate in appearance may be reduced through fillers.
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 eyes and face such as bone structure, skin tone and texture, and muscle dynamics.
Dr. Jones will also see to it that all your questions concerning the procedure are carefully answered and explained. Adjunctive procedures may be recommended as well. Get in touch with us today by calling 405.418.5400or by filling out this contact form today to schedule an appointment. We look forward to your visit!
As the third most frequently performed surgical cosmetic procedure in 2013, an eyelid surgery or blepharoplasty is also one of the recently most requested cosmetic procedures for most of our patients here at ourEdmond plastic surgery practice. Although there’s no denying the fact that an eyelid surgery can significantly improve one’s appearance, not all cosmetic issues that has to do with the eyes can be remedied with the procedure.
By and large, an eyelid surgery is ideal for you if you have the following specific concerns:
your upper and lower eyelids appear puffy, making you look perpetually tired
you have excess or loose skin hanging down from the upper eyelids or covering the natural folds of your upper eyelids
you have deep grooves underneath the eyes, popularly referred to as the eye bags
On the other hand, an eyelid surgery may not be the ideal solution if you want to remove dark circles around the eye area, address sagging upper eyebrows, and reduce the appearance of crow’s feet (fine lines and wrinkles that tend to develop on the outermost corners of your eyes) For the aforementioned concerns, injectables and laser resurfacing procedures are more appropriate. In addition, a brow lift may be more effective in addressing sagging eyebrows.
The Ideal Candidate of an Eyelid Lift
Apart from the issues mentioned above, you are an ideal candidate for an eyelid lift if:
you have excellent physical health and free from the existing health problems (or perhaps well-controlled) such as high blood pressure, thyroid problems, dry eye, diabetes, glaucoma, and cardiovascular disease.
you have realistic expectations of the procedure
you can commit to the idea of quitting smoking at least 4 to 6 weeks before your scheduled eyelid surgery
Planning for Your Eyelid Lift 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.
Dr. Jones will also see to it that all your questions concerning the procedure are carefully answered and explained. Adjunctive procedures may be recommended as well. Get in touch with us today by calling 405.418.5400or by filling out this contact form to schedule an appointment. We look forward to your visit!