Dr. Klapper specializes in cosmetic and reconstructive services of the eyelids and face.

Cosmetic surgical services include: Blepharoplasty; Endoscopic Forehead Lifting; Botox Injections; and Dermal Filler Injections (Radiesse and Restylane & Perlane). Specialized Skin Care Products (Jan Marini and SkinCeuticals) for use around the eyes are available at Dr. Klapper's offices.

Eyelid lifting typically refers to blepharoplasty surgery.  Blepharoplasty surgery is performed to remove redundant tissue from the upper or lower eyelids.  Cosmetic blepharoplasty is performed to provide a more youthful, rested eye appearance.  Upper eyelid blepharoplasty, in some cases, may be covered by some insurance carriers or Medicare if significant visual field loss is caused by redundant upper eyelid skin.

Ptosis refers to a droopy upper eyelid where the upper eyelid margin is lower than normal and, in moderate to severe cases, may be covering part or all of the pupil.  Ptosis repair may be covered by some insurance carriers or Medicare if significant visual field loss is caused by the abnormal upper eyelid position.

Blepharoplasty surgery and/or ptosis surgery are distinct eyelid operations to correct droopy eyelids. Eyelid surgery will not correct a droopy eyebrow (referred to as brow ptosis). Brow ptosis is corrected by lifting the eyebrow through incisions in the forehead. Endoscopic forehead lifting through small incisions at the edge of the hairline is an excellent cosmetic technique to elevate the forehead and eyebrow areas. Brow ptosis correction can also be corrected by removal of skin in the middle or top of the forehead.

The amount of work missed following surgery varies from patient to patient. The type of surgery performed will influence the length of recovery but different patients may heal at different rates following the same type of surgery. Certain occupations will permit returning to work sooner than other more visually or physically intensive occupations. Most out patient surgical procedures require patients to miss atleast 3-4 days of work but some surgical procedures and patient occupations may require up to 7-10 days or more away from work. Dr. Klapper will try to help you estimate how much work may be missed once you finalize a surgical plan. Go to Postoperative Care to learn more.

Following surgery, cold compresses (ice packs) and a topical antibiotic ointment are applied for 3 to 4 days followed by warm compresses. Eye patches are not required. Discomfort is usually minimal and is typically handled by acetaminophen (Tylenol®). Aspirin containing compounds and non-steroidal anti-inflammatory products (Advil, Ibuprofen, etc.) should be avoided 1 weeks prior to surgery and a few days following surgery. Most individuals will have swelling and some degree of bruising that will gradually improve over the first 1 to 3 weeks. Swelling make take weeks or months to completely resolve. Patient healing is variable with some individuals healing much quicker than others. Makeup can be applied to help hide residual bruising, usually starting two weeks after surgery. 

For upper eyelid blepharoplasty, 3-4 days off work is average while up to 8 to 10 days may be best for those patients having both an upper and lower eyelid blepharoplasty. Patient's with occupations requiring minimal physical activity may return to work sooner. Patients may have diminished blinking and incomplete eyelid closure following eyelid surgery, particularly ptosis repair. Frequent ocular lubrication may be required for several weeks or months after eyelid surgery. Contact lens wear is typically avoided during the first 3 weeks after surgery or until adequate blinking and eyelid closure returns. After Surgery Instructions

The amount of swelling and bruising varies from patient to patient and even from the left and right sides in the same patient. Mild bruising may resolve in 2-4 days, whereas more significant bruising may last 10-14 days. Patients may wish to hold blood thinner medications (such as aspirin, ibuprofen, some arthritis medications, Plavix, Coumadin, etc.) prior to surgery in order to minimize the risk of severe bleeding and bruising. Patients should only modify their medication regimen with the advice of their primary care physician, cardiologist, or other prescribing physician. 

Eyelid and facial swelling tends to worsen the first few days following surgery. Ice packs, head elevation, and rest may help minimize swelling. Swelling (edema) will often improve considerably over the first 2-3 weeks after surgery but may take several weeks and even months to completely resolve. Go to Postoperative Care to learn more.

In most cases, patients may shower the day following surgery. Unless there is a dressing that should remain dry, then the operated areas can get wet. Hair washing can also be performed the day following surgery. if a brow lifting procedure or endoscopic forehead procedure were performed, then care should be taken to avoid scrubbing in the areas of the forehead incisions. Make-up should be avoided for 2-3 weeks near incision sites. Once scabbing and crusting has resolved then make-up may be applied to the operated areas. After Surgery Instructions

Health insurance does not pay for all medical procedures. Eyelid surgery, particularly blepharoplasty and ptosis repair, may be considered cosmetic and require pre-approval (predetermination) if you and Dr. Klapper feel that your eyelid problem is causing a substantial functional deficit. Dr. Klapper will discuss with you whether your photographs and/or visual fields may, in his opinion, meet the specific criteria outlined by commercial insurance carriers. The predetermination process takes 3-6 weeks to complete depending on the insurance carrier. Lower eyelid blepharoplasty surgery is rarely covered by Medicare and is considered cosmetic in almost all cases. Brow surgery is also frequently considered a non-covered service. A referral from your primary care physician or eye doctor does not insure that insurance will cover your eyelid surgery.

Even when eyelid surgery is covered by insurance, patients remain responsible for office copays, surgery coinsurance, and patient deductibles. Patients should contact their insurance carrier or agent if they are unsure of their insurance benefits. Klapper Eyelid & Facial Plastic Surgery Financial Policy