The short answer is yes, but there are specific criteria that must be met. For people in Manhattan who have eyelids with excess skin or fat that causes the skin around the eye to interfere with vision, eyelid surgery can be considered medically necessary.
Criteria to Consider
In order for eyelid surgery to be considered medically necessary by insurance plans or Medicare, it must meet certain criteria. The increase in eyelid surgeries over recent years means that the procedure is under heightened scrutiny by providers. Each case is different, and considered on its own merits. In general, your blepharoplasty may be considered medically necessary if:
- Vision testing confirms that the skin of your upper eyelid interferes with your peripheral vision
- Eyelid surgery would improve your vision by a specific number of degrees
- You experience serious difficulty reading
- Straining to hold your eyes open, even when not tired
- Headaches from constantly raising your brows
- Neck strain from tilting the head back to compensate
- Eyelashes are forced into the eye causing constant irritation or inflammation
Age is often a consideration as well. For people in their 40s and 50s, eyelid surgery is more often considered to be cosmetic surgery rather than functional. If you would like to know if your eyelid surgery may be considered medically necessary, please call Manhattan Surgical Care at 212-308-1566 to schedule a consultation with experienced cosmetic surgeon Dr. Basil Pakeman, MD, FRCS. We serve patients in New York City and throughout New York State.