Four Lid Blepharoplasty
Quad blepharoplasty, also called combined upper and lower eyelid blepharoplasty surgery, removes excess eyelid fullness and heaviness by removing bulk and fat from both upper and lower eyelid areas. Often referred to as a “4 lid blepharoplasty,” this is a procedure that can improve both the upper and lower eyelids at the same time. This offers a full eyelid rejuvenation in one surgery, allowing for a single recovery, and helping patients achieve their goals more quickly.
- The upper eyelid part of the surgery addresses extra skin and fat that can make the eyes look closed or tired.
- The lower eyelid blepharoplasty removes fat and bulk from the lower eyelids, often referred to as “eyelid bags.”
Why should I get Quad blepharoplasty surgery?
What is the surgery like?
We perform four lid blepharoplasty in one of two locations – our office or in an outpatient surgery center. The primary difference between these two locations is the use of sedation during your surgery. In our office, we are unable to provide you with systemic sedatives and rely only on a local anesthesia to keep you comfortable. In the operating facility, you will get sedation through an IV that will relax you, in addition to the same local anesthesia as with the office procedure. Prior to beginning surgery, Dr. Dewan will confirm the surgical plan that was discussed during your consultation, and then make appropriate marks on your eyelids for surgery. Surgery then begins with Dr. Dewan numbing your eyelids with the anesthetic. As the surgery progresses, Dr. Dewan will make adjustments to the eyelids as necessary and may ask you to look in various directions to achieve the best results. You will leave with bandages covering the incisions, though you will be able to see around them. Quad blepharoplasty can take up to two hours.
Can I wear makeup afterward?
What is the recovery like for Quad BLEPHAROPLASTY?
Most patients have minimal pain and only need the occasional Tylenol or ibuprofen to treat it. Any stitches that are used will dissolve between 7-10 days after surgery and swelling and bruising last about the same amount of time. Early application of ice packs helps to minimize the swelling. Even with modest swelling, most people are able to perform normal activities within 1-2 weeks, with most activities able to be done within just 1-2 days. One week after your surgery, you will return for a post-operative visit, which will allow Dr. Dewan to check that everything is healing well.
Will my eyelids have scars after surgery?
Dr. Dewan’s expertise combined with the unique features of the eyelid skin ensure that scarring is minimal in the eyelids
- For upper eyelid blepharoplasty, the incision Dr. Dewan makes is hidden within your natural eyelid crease. This makes for a virtually invisible scar after it has had a chance to heal.
- For lower eyelid blepharoplasty, if skin is necessary to remove, the incision is made just underneath your eyelashes. This incision is designed to fall into the natural lines of the eyelid skin created by eyelid muscle contraction, and is typically not visible after you have had a chance to heal.
- If no skin removal is needed, the incision for lower eyelid blepharoplasty will often be made on the underside of the lid, allowing the fat to be removed without making a skin incision at all. This heals very nicely and patients will never feel or see a scar.
What other surgeries are performed with combined Quad blepharoplasty?
- Occasionally patients choose to have additional procedures performed to further enhance their eyelid rejuvenation. These include:
- Some patients would like to have a “mini-facelift” at the same time as lower eyelid blepharoplasty, so cheek lifting and support are a common procedure done simultaneously.
- Other patients would like to alter the shape of the eye, creating a sharp, upswept outer corner of the eye, referred to as canthoplasty or “almond eye surgery.”
Some patients may also have a droopy eyebrow or need a muscle repair (ptosis repair) for an eyelid. These procedures can also be performed at the time of a blepharoplasty.
Before and After
Will insurance pay for this?
Upper and lower eyelid blepharoplasty are treated differently by insurance companies. Upper eyelid surgery may be covered by your insurance company if we can prove that your vision is being affected by your eyelids. There are specific measurements and testing that Dr. Dewan will conduct if it appears that your eyelids may be affecting your vision. We send this information to your insurance company for prior authorization for surgery, and if approved, your insurance will cover the upper eyelid blepharoplasty portion of a combined eyelid surgery. Lower eyelid blepharoplasty is typically considered a cosmetic surgery and, as such, is not covered by insurance. During your consultation, Dr. Dewan will make measurements and provide an opinion on the best approach for your lower eyelid surgery. He will also provide you with a quote for your surgery, including estimates for the surgery center fees.
the best results.