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Blepharoplasty, commonly known as eyelid surgery, is a procedure that addresses excess skin, fat, or muscle around the eyelids. For some individuals, this may be performed for cosmetic reasons, but for others, drooping (ptotic) or heavy upper eyelids can cause significant functional problems. These may include obstruction of vision, difficulty wearing glasses, skin irritation, and even discomfort in the forehead from constantly raising the eyebrows to lift the eyelids.
Many patients in Newcastle and the Hunter region seek clarity on whether Medicare can contribute to the cost of blepharoplasty when performed for medical reasons.
Dr. Yezdi Mistry, Specialist Plastic & Reconstructive Surgeon in Newcastle, regularly assists patients in answering this question. His practice helps individuals understand Medicare’s requirements, assess their eligibility, and explore treatment options that support both function and wellbeing.
Medicare is Australia’s universal health insurance system and is designed to provide rebates for medical services considered clinically necessary. In the context of blepharoplasty, this means that surgery performed solely for cosmetic change is not covered. However, if eyelid surgery is required to restore function or relieve medical symptoms, it may attract a Medicare rebate under specific Medicare Benefits Schedule (MBS) item numbers (#45617 Upper, #45620 Lower).
Not every patient experiencing eyelid concerns will qualify for Medicare assistance. The system requires clear evidence that the surgery is medically necessary. Eligibility criteria may include:
If these requirements are satisfied, an MBS item number may be applied, making you eligible for a Medicare rebate. If you’re considering this procedure and want to understand its potential benefits beyond Medicare coverage, explore what eyelid surgery can help with.
Understanding the difference between these two categories is important, as it determines whether Medicare assistance applies.
While Medicare may provide partial coverage when medical necessity is demonstrated, it does not usually cover all costs. Patients will still incur:
Private health insurance may assist with some of these additional expenses, but coverage varies between funds. During your consultation, you will be provided with detailed information about potential costs so you can make an informed decision.
When considering blepharoplasty, it is important to seek care from a fully qualified Specialist Plastic Surgeon. Dr Yezdi Mistry, based in Charlestown, Newcastle, is a FRACS (Plastic Surgery) qualified surgeon and a member of the Australian Society of Plastic Surgeons (ASPS). With extensive training in both reconstructive and aesthetic procedures, he offers patient-focused care, ensuring that each assessment is thorough and guided by best clinical practice.
No. Medicare only provides assistance when the procedure is medically necessary and eligibility criteria are met.
Visual field testing is usually required to confirm that drooping eyelids obstruct vision. Clinical photographs may also be requested.
Yes. A referral from your GP is necessary to access a Medicare rebate for a Specialist Plastic Surgeon consultation.
Yes, provided you have the appropriate level of cover. Each health fund differs, so it is important to confirm your policy inclusions with your provider.
There is no set age requirement. Eligibility is based on clinical symptoms and test results rather than age alone.
Medicare rebates generally only apply to upper eyelid surgery when vision is affected. Lower eyelid blepharoplasty is considered cosmetic.
Yes, in some patients. Constantly raising the eyebrows to lift drooping eyelids can cause forehead muscle fatigue and headaches. If these symptoms are present, and supported by evidence of obstruction, Medicare may assist.
Blepharoplasty can provide long-lasting results, but ageing continues to affect the skin and muscles over time. Some patients may notice changes again years after surgery.
Blepharoplasty is a procedure that can offer relief from functional symptoms such as impaired vision, eyelid irritation, and forehead strain. While Medicare does not provide coverage for cosmetic eyelid surgery, patients who meet strict clinical criteria may be eligible for rebates under the Medicare Benefits Schedule.
For those considering blepharoplasty in Newcastle, Dr Yezdi Mistry, Specialist Plastic & Reconstructive Surgeon in Charlestown, provides comprehensive consultations to evaluate eligibility, guide patients through the Medicare process, and explain surgical options clearly.
To make an appointment for a consultation, call us on (02) 4062 7888 or reach out on the Contact Us page.
Dr Yezdi Mistry is a Specialist Plastic and Reconstructive Surgeon based in Newcastle, NSW. With extensive training and experience in both reconstructive and aesthetic surgery, Dr Mistry is committed to providing safe, evidence-based care that is tailored to each patient’s individual needs.
After completing his Fellowship of the Royal Australasian College of Surgeons (FRACS) in Plastic Surgery in 2013, Dr Mistry relocated to Newcastle with his family in 2015. He began his work as a Visiting Medical Officer (VMO) in Plastic and Hand Surgery at John Hunter Hospital before establishing his private practice in 2017. His practice offers a comprehensive range of reconstructive and aesthetic procedures for the breast, body, face, and skin.
Dr Mistry’s approach to patient care is grounded in trust, respect, and open communication. From initial consultation to recovery, he aims to ensure patients feel informed, supported, and comfortable throughout their surgical journey. He is dedicated to maintaining the highest professional and ethical standards in all aspects of his work.
To remain at the forefront of modern surgical techniques, Dr Mistry continues to pursue ongoing professional development both in Australia and internationally. He was Australia’s first delegate at the Body Contouring Academy in Paris, where he received advanced training in body contouring and skin-tightening techniques, including VASER and RENUVION technologies.
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Please Note: Information provided on Dr Mistry’s website is provided as a basic guide, it does not constitute a diagnosis and should not be taken as medical advice. Any surgical or invasive procedure carries risks.
“I care because it’s my job as a surgeon, as a plastic surgeon, to do the appropriate thing and to give you a good outcome. I want to leave knowing that I can tell a patient, hand on heart, that I did the very best I could and that I looked after them, so when I see them post op later that day or the next morning, that they feel they were in good hands.”
– Dr Yezdi Mistry
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