Dermatochalasis is excess upper eyelid skin. Many patients, as they age, develop excess upper eyelid skin that can fold upon itself, causing skin irritation and visual interference if it pushes over the eyelid margin and pupils. Blepharochalasis is a subset of dermatochalasis characterized most commonly in young to middle-aged females by bouts of recurrent eyelid swelling that can lead to skin stretching, thinning, and overhanging of the eyelid margins and pupils.
Many times, dermatochalasis occurs with other age-related problems, such as dry eyes, ptosis of the eyelid margin or eyebrows, and lower eyelid drooping. Any plastic surgeon can perform an eye lift “blepharoplasty,” but only an ophthalmologist (eye surgeon) is best suited to identify other comorbidities, such as subtle dry eye issues and ocular swelling that can be greatly exacerbated following upper eyelid surgery. Blepharoplasty surgery is covered by insurance for medical reasons when vision compromise is confirmed by visual field testing and ocular photography.
Commercial insurances differ on their criteria for coverage, but all patients need to also be suffering visual problems from the excess skin, such as difficulties with reading and driving activities. Otherwise, blepharoplasty surgery is viewed as a cosmetic procedure only. A large part of Dr. Burroughs’ practice is cosmetic (self-pay) only, but he always will advocate for insurance coverage of procedures when the eye health and vision is being compromised.