Functional Versus Cosmetic Oculoplastic Surgery

Functional vs Cosmetic Eyelid Surgeries

The question of functional versus cosmetic surgery arises often. Here is the difference between the two:

More than 170,000 people in the US each year get some form of eyelid surgery. Most of those people average around 57 years of age. Sometimes , the need is more cosmetic and others, it’s more so for medical purposes like cancer and uncomfortable situations.

What Does “Functional” Surgery Mean?

Functional (or reconstructive) oculoplastic surgery is considered medically necessary and is usually covered by health insurances. It is designed to help with the function of the eyelid or periorbital areas. Examples include ptosis (droopy eyelid), eyelid malpositions (ectropion, entropion), eyelid retraction, eyelid tumors or skin cancer reconstruction, lacrimal tear duct (DCR) surgery, orbital tumors, bulgy eyes, thyroid eye disease, trauma (eyelid laceration, orbital fractures), orbital tumors, eye socket surgery, facial or eyelid paralysis, and facial or eyelid spasms.

What Does “Cosmetic” Surgery Mean?

Aesthetic (or cosmetic) oculoplastic surgery is not medically necessary and is not covered by health insurances. It is done to improve the appearance of the eyelids and surrounding regions (brow or forehead, cheeks, face). Some of the common aesthetic oculoplastic operations include upper blepharoplasty (lid lift), lower blepharoplasty (eye bag removal or dark circles), eyebrow or forehead lift, canthoplasty, midrace or cheek lift, eyelid or facial fillers (Restylane, Juvederm, Radiesse, Sculptra), fat transfer or fat graft to eyelids or face, and skin laser resurfacing or peel.

Some procedures, such as upper blepharoplasty, can be either functional or aesthetic, depending on its severity and effect on the eye/vision. There are certain criteria that need to be met and tests done in order to differentiate when there is gray line.

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