Does Insurance Cover Upper Blepharoplasty?*

It is pretty uncommon for insurance companies to cover procedures that are often felt to be cosmetic. For example, breast reduction is frequently covered if the large breast size causes neck pain back pain and shoulder grooving. Extensive documentation is required. The result of breast reduction is smaller more shapely breasts-So there is cosmetic improvement. Upper eyelid surgery is sometimes covered by insurance provided that documentation of significant obstruction of visual fields particularly upward gaze and even lateral peripheral vision Is demonstrated to cause visual disturbances. Visual field testing is required. This patient had a unique situation that resulted in treatment of a medical condition and secondary benefit of improved upper eyelid appearance. She had a enlarging lesion on her left upper eyelid in a very difficult location over the tarsal area which is the part of the eyelid directly above the eyelashes. Dr. Lyle removed the lesion which turned out to be a benign wart -like lesion. The resulting defect was resurfaced with a very thin skin graft which was actually harvested from her opposite upper eyelid-Taken in the design of a blepharoplasty. Removal of this lesion alone would have left her with significant deformity, so the upper eyelid Incisions were matched-for symmetry. Dr. Lyle no longer participates with insurance companies.