Bilateral Ptosis Repair (Insurance), Bilateral Upper Blepharoplasty (Self Pay), and Bilateral Lower Blepharoplasty (Self Pay) FAQs
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Bilateral means surgery on both sides. Click to read about upper blepharoplasty and see photos.
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Click to read about ptosis repair and see photos.
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Click to read about lower blepharoplasty and see photos.
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Due to insurance rules, medical insurance cannot be used for both upper blepharoplasty and ptosis repair surgeries when performed at the same time even if vision is being impacted. You can read more on our blog. Lower blepharoplasty is considered cosmetic and is not an insurance approved benefit.
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The surgery is performed at Blue Ridge Surgery Center. Review additional information about the facility.
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An adult will have to drive you to surgery, stay there, take you home, and stay with you for 24 hours after surgery. You and your guest will be at the surgery center for approximately 5 hours.
You cannot drive for 24 hours after anesthesia and you should not drive if your vision is blurry (more below).
Avoid surgery within 3 months of any major events (weddings, family reunions, etc.).
For the upper blepharoplasty, long acting sutures are used to help reform the eyelid crease. These sutures may take over a month to dissolve. Consider this a short term sacrifice for a long term gain. Expect bruising and swelling after surgery. Though the bruising and swelling will not be fully resolved after 14 days, many patients are socially presentable after 14 days (aside from having the aforementioned sutures in place at this time). Make up can be used on day 11.
For the ptosis repair, contact lenses are placed by Dr. Mettu at the time of surgery to help minimize irritation from sutures on the inside of the eyelid. These do not require maintenance, are comfortable, and are safe to leave in. Dr. Mettu will remove the contact lenses at the first post op visit.
After ptosis repair, vision may be very blurry initially due to bloody tears and blood clots on the inside of the eyelids. Blurry vision will steadily improve over the course of a few days and typically improves further once the contact lenses are removed.
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Avoid strenuous activity until day 11 after surgery. On day 11, you may resume exercise at 50% effort and slowly build back up.
Avoid bending and lifting until day 11.
Do not rub, pull, or press on the eyelids.
Do not go swimming until day 11 after surgery. Incisions may get wet and you may shower but avoid direct pressure from the shower head.
Do not drink alcohol until day 11 after surgery as alcohol can thin your blood and increase the bleeding risk.
Do not wear make up until day 11 after surgery.
Do not wear contact lenses until day 15 after surgery.
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At the pre op appointment, we will send in the prescriptions for you.
We will prescribe an antibiotic ointment to use on the sutures three times a day for ten days and then nightly until the sutures dissolve.
We will also prescribe antibiotic eye drops to use three times a day for ten days.
You should also have the following over the counter medications available for use post operatively:
artificial tears to use as needed for dryness/irritation
Tylenol for post operative pain (if this does not adequately reduce your pain to a tolerable level, please let us know).
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You will need to use ice packs after surgery.
They should be light weight so as not to put too much pressure on the surgical area and sutures.
Frozen ketchup packets in a clean ziplock bag work well.
You can also purchase reusable freezable gel packs if desired.
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We will schedule the first post op appointment typically 5-7 days after surgery at which time the contact lenses will be removed. Sutures will not be removed - they will be allowed to dissolve as noted above. There is one more post op appointment approximately 2-3 months after surgery. After that time, patients follow up as needed.
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After the initial consult, we see patients again prior to surgery (usually around 1-2 weeks) for a pre op visit. Before the pre op visit, you should review the following information again:
Review all of the information on this page in detail.
Review the pre op instructions.
Review the post op instructions.
Review the bilateral upper blepharoplasty consent form (you will sign this in the office at the pre op visit).
Review the ptosis repair consent form (you will sign this in the office at the pre op visit).
Review the bilateral lower blepharoplasty consent form (you will sign this in the office at the pre op visit).
You should also come to the pre op visit prepared with questions or send us any pressing questions in advance.
Contact your insurance company as noted below with questions about insurance related costs.
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Based upon your insurance, our best estimate for the surgeon's fee will be prepared around 1-2 weeks prior to surgery and provided to you by text message or at the pre op visit. The amount will depend on your specific insurance contract and typically reflects unmet deductible or coinsurance. The amounts are not arbitrarily set by our office - they are dictated by your insurance plan. Payment for the surgeon's fee is due at the pre op visit. Once the claim comes back from your insurance company, you will receive an explanation of benefits (EOB). We will contact you if any adjustments (issuing a refund or collecting additional balance) need to be made, but you should reach out to us as well if you have questions once you have your EOB.
There will also be claims submitted by Blue Ridge Surgery Center and the anesthesia group. You may also have some financial responsibility for the facility fee and the anesthesia fee based upon your insurance contract. Unfortunately, due to the complexity of medical insurance billing, we cannot provide estimates for your facility fee and anesthesia group (more info below.)
The best source of info for cost related questions will be your insurance company. You can contact them by calling the number on the back of your card.
Here is some info your insurance company may ask for:
The CPT code for your surgery will be:
67908 bilateral ptosis repair
Pradeep Mettu, MD NPI is 1215236419
Blue Ridge Surgery Center NPI is 1073578019
For questions about facility fees at Blue Ridge Surgery Center, call 919-781-4311.
For questions about anesthesia billing through American Anesthesiology, call 866-306-6007. If you are asked how long the insurance portion of the surgery may take, an estimate for this purpose is 75-90 minutes.
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The self pay quote for bilateral upper blepharoplasty and bilateral lower blepharoplasty at Blue Ridge Surgery Center when combined with insurance based surgery is $7,050. This includes the surgeon's fees, anesthesia fees, and facility fees.
The amount above will be paid in two transactions:
$5,550 will be due to the office at the pre op visit for the surgeon's fee and anesthesia fees.
$1,500 will be due to Blue Ridge Surgery Center for the facility fee. We recommend calling Blue Ridge Surgery Center at 919-781-4311 at least a few days prior to the day of surgery to complete payment so we can help address any questions that could come up.
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Surgery times are finalized by the surgery center the day prior to surgery. You will be contacted by Blue Ridge Surgery Center with your arrival time. If you do not hear from them the day prior to surgery, between 2 pm and 4 pm the day prior to surgery, Call 919-781-4311 and press option 1 to get your arrival time.
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If you are an existing patient who has been seen in our office recently, were sent this information to review, and are interested in proceeding with surgery, text and let us know:
if you need a quote for insurance based bilateral ptosis repair
if you would like to pursue insurance based bilateral ptosis repair alone or in combination with self pay bilateral upper blepharoplasty and self pay bilateral lower blepharoplasty
dates you CANNOT do with regard to the pre op visit, surgery date, and first post op visit
we will then text you proposed dates based upon our availability (Dr. Mettu operates on Wednesdays and Fridays)
once a date for surgery is finalized, we will use the date to submit for authorization from your insurance for the bilateral ptosis repair
If you have not been seen in our office and would like to be evaluated, you can schedule online.
If you are scheduled for surgery and are reviewing this information before your pre op appointment, see you soon!
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