Common Questions

What cosmetic services are available at Dr. Klapper’s offices?

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

Cosmetic surgical services include: BlepharoplastyEndoscopic Forehead LiftingBotox 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.

Will eyelid surgery correct my droopy eyebrow?

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.

Will insurance help pay for my surgery?

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

What type of anesthesia is used during surgery?

Office procedures are performed with local anesthesia which may include eye drops and small injections under the skin in the area requiring surgery.

Surgeries performed in an ambulatory care center or hospital are usually performed with intravenous sedation administered by an anesthesiologist. Some surgeries, such as orbital procedures, are performed under general anesthesia.

Dr. Klapper will be able to discuss anesthesia options once a surgical plan has been developed.

What are the risks of eyelid surgery?

The expectations and risks associated with eyelid surgery may depend on the type of eyelid procedure(s) and may also vary from patient to patient. Patiet compliance with postoperative instructions is critical to achieve the most optimal surgical result. Even in the best of surgical hands, unexpected results may occur.

Excessive pain, bleeding, and infection are very uncommon. Severe loss of vision following eyelid surgery has been reported but fortunately is extremely rare (approximately 1 in 2,000 cases). It may occur if deep orbital hemorrhage (bleeding) occurs postoperatively. This typically would occur within the first 24 hours following surgery, so it important for patients to have a responsible adult with them the afternoon, evening, and day following eyelid surgery. Incomplete eyelid closure and inadequate lubrication of the eyes following surgery (ex/ upper eyelid ptosis repair) may also result in corneal scarring or infection causing vision loss. it is critical for patients to understand the signficant risks associated with eyelid surgery and recognize the role the patient will have in their recovery and follow-up. Communication with Dr. Klapper and his staff regarding any concerns, particularly relating to vision or pain, is essential to potentially reduced the consequences of unexpected events following eyelid and other oculoplastic surgical procedures.

What Is Different about Medicare Coverage?

Medicare does not pay for everything. With Medicare, the decision to cover surgery is not made until after surgery when the claim is submitted from the doctor’s office. Medicare does not have a pre-approval (predetermination) process. Dr. Klapper will discuss with you whether your photographs and/or visual fields may, in his opinion, meet the specific criteria outlined by the local carrier for Medicare. Dr. Klapper can not, however, guarantee whether your surgery will be a covered service. Lower eyelid blepharoplasty surgery is rarely covered by Medicare and is considered cosmetic in almost all cases. A referral from your primary care physician or eye doctor does not insure that Medicare will cover your eyelid surgery. All Medicare patients considering functional blepharoplasty and/or ptosis surgery will be asked to sign Medicare’s Advance Beneficiary Notice of Noncoverage (ABN) indicating that you understand your financial responsibility if Medicare does not cover your surgery. Similarly, Medicare patients electing to proceed with blepharoplasty, ptosis, or brow/forehead lifting procedures that do not appear to meet Medicare’s criteria for medical necessity will also be asked to sign Medicare’s Advance Beneficiary Notice of Noncoverage (ABN) indicating that the procedure(s) is(are) considered cosmetic, non-covered service(s) and will not be filed with Medicare. Secondary insurance carriers generally follow Medicare guidance.  Klapper Eyelid & Facial Plastic Surgery Financial Policy

Dr. Klapper

Droopy Eyelids

Introduction to Droopy Eyelid and Eyebrow Surgery


Eyelids that appear droopy as a result of “redundant” eyelid tissue (skin, muscle, and/or fat) may benefit from removal of this “extra” eyelid tissue. This surgical procedure is called a blepharoplasty. Motivation for blepharoplasty surgery may be either functional (to improve visual field) or cosmetic (to improve upper facial appearance). Blepharoplasty surgery can be performed on either the upper or lower eyelids. Lower eyelid blepharoplasty surgery is almost always considered a cosmetic procedure. Blepharoplasty surgery may be combined with upper eyelid ptosis repair and/or eyebrow and forehead lifting.

Ptosis Surgery

Ptosis (pronounced “toe-sis”) refers to an actual drooping of the upper eyelid margin near or covering the pupil. Ptosis surgery is performed to tighten the internal muscles of the eyelid and elevate the eyelid to a more normal position. Ptosis surgery may be combined with blepharoplasty surgery and/or brow and forehead lifting.

Eyebrow and Forehead Lifting 

Eyebrow droop or brow ptosis may occur as a result of aging or familial facial characteristics. Droopy eyebrows often contribute to upper eyelid fullness or skin redundancy. It is important to recognize eyebrow ptosis when considering surgery to correct droopy eyelids.

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Dr. Klapper treats disorders, injuries, and other abnormalities of the eyelids, eyebrow, tear duct system, eye socket, and adjacent areas of the mid and upper face.

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