Cicatricial Ectropion Repair with Skin Graft FAQs

• What is ectropion repair?

  Cicatricial ectropion refers to the lower eyelid pulling down due to tight skin or scar tissue. Click to read about ectropion repair and see photos.

• Where is the surgery performed?

  The surgery is performed at Blue Ridge Surgery Center. Review additional information about the facility. 

• What are the planning considerations?

  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 3.5 hours.

  You cannot drive for 24 hours after anesthesia. It may be necessary to temporarily close the operative side with a bandage. You should not drive when one eye is covered.

  Avoid surgery within 3 months of any major events (family reunions, weddings etc.).

  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 potentially visible sutures as noted below). Make up can be used on day 11.

  Any bandages are often removed after one week.

  Dissolvable sutures are otherwise used for surgery. It may take over a month for some of the sutures to dissolve.

• What are the restrictions after surgery?

  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 for 21 days.

  Do not go swimming until day 11 after surgery. The eyelid 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 your own contact lens on the operative side until 3 weeks after surgery.

• What medications will I need after surgery?

  At the pre op appointment, we will send in the prescriptions for you.

  We will prescribe antibiotic ointment to apply to the incisions.

  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)

• When are the post op appointments?

  We will schedule the first post op appointment typically around 7-10 days after surgery to remove bandages.

  Sutures will otherwise not be removed - they will be allowed to dissolve.

  There is one more post op appointment approximately 2-3 months after surgery.

  After that time, patients follow up as needed.

• What else do I need to do to prepare for surgery?

  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 ectropion repair 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.

• What is the cost?

  Here is a break down of the insurance costs for cicatricial ectropion repair:

  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 codes for your surgery will be:

  15260

  67917

  67875

  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 45-60 minutes for 1 eyelid and 60-75 minutes for 2 eyelids.

• What time will my surgery be?

  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.

• What happens next?

  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 ectropion repair

  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).

  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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