By Dr Ehsan Jadoon
Please note: MedAesthetics is a non-surgical cosmetic medicine clinic and does not perform blepharoplasty (eyelid surgery). The information below is general education about how Medicare rebate rules apply to this surgery in Australia. It is not an offer of surgery.
Upper eyelid lift — also called upper blepharoplasty — is a surgical procedure that removes or repositions excess skin, and sometimes muscle and fat, around the upper eyelids. A common question people research is whether this surgery attracts a Medicare rebate. This article explains, in general terms, when a rebate may or may not apply.
The two broad types of upper eyelid blepharoplasty
Upper eyelid blepharoplasty can be divided broadly into two categories:
- Traditional blepharoplasty, which involves excision of part of the orbicularis oculi muscle (the thin muscle encircling the eye) and removal of deeper fat pads.
- Tissue-sparing blepharoplasty, which involves removal of excess eyelid skin only; the deeper structures of the upper eye described above are not removed.
Which approach, if any, is appropriate is a clinical decision made by the surgeon performing the procedure after assessing the individual.
When do Medicare rebates apply?
In Australia, Medicare rebates for upper blepharoplasty are applicable only when the surgery is performed to improve a person’s field of vision — that is, for a functional, medical reason rather than for appearance alone.
For some people, often from around their 60s onward, loose upper-eyelid skin can obscure the outer field of vision. This can make certain daily tasks — such as driving — more difficult and may increase the risk of falls. Where a doctor assesses that the functional criteria are met, the procedure may attract a rebate.
Cosmetic blepharoplasty, on the other hand, is performed solely to change facial appearance, and no Medicare rebate currently applies in that case. Any clinic offering cosmetic blepharoplasty under Medicare is potentially in breach of Medicare rules and regulations. Whether an individual meets the functional (vision) criteria is determined by clinical assessment.
Risks associated with eyelid surgery
Like any operation, upper eyelid surgery is a serious, considered decision and carries risks. Potential risks associated with this surgery generally include:
- Swelling and bruising: common after eyelid surgery; these usually settle within a few weeks but vary from person to person.
- Infection: although uncommon, infection can occur at the incision sites; surgeons take precautions to reduce this risk.
- Scarring: incisions are placed to be as inconspicuous as possible, but scarring is still possible.
- Haematoma: a collection of blood under the skin, which may require drainage if significant.
- Nerve-related changes: temporary numbness or altered sensation is possible; this usually resolves over time but, rarely, can persist.
- Asymmetry: exact symmetry between the two sides cannot be guaranteed in any procedure, and slight differences may remain.
- Skin irregularities: changes in skin texture or contour can occur, particularly if healing is not optimal.
- Anaesthesia risks: anaesthesia carries inherent risks, including reactions to medications and rare complications.
- Unsatisfactory results: satisfaction with the outcome varies between individuals; realistic expectations and clear communication with the surgeon performing the procedure are important.
- Revision surgery: in some cases, further surgery may be needed to address complications or refine the result.
Recovery time and the recovery experience also differ between individuals. Anyone considering eyelid surgery should discuss the benefits, limitations and risks in full with the surgeon who would perform it. Individual results vary.
Exploring non-surgical options
MedAesthetics does not perform blepharoplasty. If you are exploring non-surgical options relating to the appearance of the upper eye area, an individual consultation can explain what may — or may not — be appropriate for you, along with the benefits, limitations and risks involved. No treatment is presented as the only option, and outcomes depend on the individual. If you would like to discuss this, you can arrange a consultation.
