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Chris Thiagarajah MD

Common Questions patients have about Blepharoplasty or Cosmetic Eyelid Surgery





Before blepharoplasty surgery there are some common questions that patients have. Often these are things that many patients think about before cosmetic eyelid surgery. This article includes the most common questions that patients have and the answers that most surgeons won't give you. Read below and you can get the inside scoop on cosmetic eyelid surgery from a cosmetic eyelid specialist who has performed 1000s of them.


When does insurance cover eyelid surgery?


Insurance covers blepharoplasty or eyelid surgery when it is medical necessary. What does that mean exactly? That means if the eyelids are blocking your vision or impairing it to the level that insurance will cover. For the lower eyelids it is never covered. Puffiness of the lower eyelids never impairs vision. For the upper eyelids there has to be enough excess skin that it falls under insurance coverage. The insurance company will look at your photographs and see if the skin hangs over the eyelashes and is within 2mm from the pupil. That is essentially the key criteria. If it is does, they will want to see symptoms such as "affecting reading" or "can't see well to drive" to know it is affecting your daily life activities. Finally that will have to be confirmed with a test in the office called a visual field. All three are needed for insurance coverage. Without the first criteria they don't care what the visual symptoms or visual field test shows. The skin has to be within 2mm of the pupil.


I am worried about "looking different" after surgery. How often does that happen?


Patients will look different after eyelid surgery. That is essentially the key to cosmetic eyelid surgery. Anyone who tells you it won't is lying. By definition the surgery is changing the appearance. Sometimes the eyelid shape or appearance can be slightly different. Most often this is done in a more aesthetically pleasing way. Often patients feel they look refreshed and better. If you are interested in looking "exactly the same" after surgery, I would recommend not doing it. That is literally impossible.


Will I ever need eyelid surgery again after getting Dr Thiagarajah to perform eyelid surgery?


I tell patients often that I don't stop the aging process. That being said, patients often get eyelid surgery once in their life. Why is that possible? Often when patients come for cosmetic eyelid surgery they feel their eyes are aged at a level far advanced than their chronological age. So a 45 year old feels their eyelids look 55 for example. After surgery, the eyelids are reset to say age 40 and then age with the patient. Most often this patient will always feel their eyelids are chronologically at their biological age. So when they are 65, their eyelids are those of a 65 year old which they are happy with. That is why even though the aging process is not stopped, patients often get eyelid surgery once in their lives.


Do I really need a specialist to perform my eyelid surgery?


In short yes. Would you have a cataract surgeon perform heart surgery on you? Or vice verse? The eyelids are a specialized structure that need specialized skill. This doesn't mean that complications don't occur with eyelid specialists or oculoplastic surgeons. They do. But in my opinion they occur at a lower rate. My partner and I see complications from eyelid surgery in Denver in our office all the time. I have never heard of an eyelid specialist having a patient with a complication from blepharoplasty and sending it to a non-specialist to fix. The opposite occurs all the time. You can make your judgement for who should do it from that.


My eyelids really bother me but my spouse/friends say I should just "age gracefully". What should I do?


In short "Who cares what others think". The decision to get eyelid surgery is a personal one. It is solely based on whether it bothers you, not your spouse or friends. If your friends think you eyelids are fine and you shouldn't get surgery that is great but they don't live with your eyelids. They don't have people asking if they are tired or sleepy because of their eyes. Maybe they do but don't have the resources to do anything about it. Then they have to self rationalize that it is better to "age gracefully".


Who is the best eyelid surgeon in Denver?


There are some great eyelid surgeons in Denver. The best one is a personal decision based on who has the experience, skills, communication skills and bedside manner. This is based on objective criteria but also on subjective criteria and is a personal decision. If someone claims they are the best eyelid surgeon in Denver it shows a lack of understanding of what makes a great surgeon and an extremely superficial understanding of surgical skill. I am an excellent surgeon but I will reserve terms like "best" or "greatest" for my patients and makes to judge. Just like it sports, if someone claims they are the greatest, it means they probably are not.


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