Blepharoplasty, commonly known as eyelid surgery or an eyelid lift, is a cosmetic procedure to enhance the appearance of the upper and lower eyelids. As we age, eyelid skin can become loose and saggy, and eyelid fat can bulge – making us look tired, sad or angry. Blepharoplasty surgically removes excess fat, muscle and sagging skin to create a more alert, positive and youthful appearance.
In this comprehensive guide, we will focus specifically on 4 lid blepharoplasty – where all four eyelids (upper and lower) are addressed in one surgery. We will cover everything you need to know about this transformative procedure, from candidacy to recovery.
Who is a Good Candidate for 4 Lid Blepharoplasty?
The ideal 4-lid blepharoplasty candidates are men and women bothered by the following:
- Loose, sagging or wrinkled upper eyelid skin
- Under eye bags and puffy lower eyelids
- Excess lower eyelid skin and fine lines (“crow’s feet”)
- An overall tired, sad or aged facial appearance
Good candidates are typically in their 30s to 60s with visibly ageing eyelids but otherwise in good health. The best candidates have realistic expectations for the procedure. 4 lid blepharoplasty will refresh and rejuvenate the eye area but cannot stop normal ageing.
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4 lid blepharoplasty can be performed as young as the early 30s when genetic tendencies become apparent. However, waiting until signs of ageing appear allows the surgeon to address your specific concerns.
4 Lid Blepharoplasty Benefits
The goals and benefits of lower and upper 4 lid blepharoplasty (performed together) are:
Upper Eyelids
- Remove loose, excessive skin for a tighter upper lid
- Eliminate under-eye bags and puffiness
- Reduce upper eyelid hooding obstructing peripheral vision
- Open up and brighten your eyes for a more alert expression
Lower Eyelids
- Tighten loose, sagging lower eyelid skin
- Minimise lower eyelid wrinkles and crepey skin
- Reduce lower eyelid bags under the eyes
- Reveal more visible eyelid platform
Overall, 4 lid blepharoplasty creates upper and lower eyelids that appear more symmetrical, refreshed and aesthetically appealing. The transformation leads to looking and feeling younger and more energetic.
How is 4 Lid Eyelid Surgery Performed?
4 lid blepharoplasty can be performed under local anaesthesia with sedation or with general anaesthesia, depending on the extent of correction needed. The procedure normally takes 1-3 hours to reshape the upper and lower eyelids meticulously.
There are a few surgical techniques the plastic surgeon may utilise depending on your concerns, anatomy and aesthetic goals. Common techniques include:
Upper Blepharoplasty Techniques
- Transcutaneous Blepharoplasty: Excess skin removal + fat removal/repositioning through an upper lid skin incision
- Transconjunctival Blepharoplasty: Fat removal through an interior upper lid incision
- Levator Muscle Repair: Stitches to tighten the drooping levator muscle
Lower Blepharoplasty Techniques
- Skin Pinch Blepharoplasty: Excess lower lid skin removal
- Transconjunctival Blepharoplasty: Lower lid fat removal through interior incision
- Lower Lid Retightening: Internal sutures to lift lower lid tissue
- Canthopexy/Canthoplasty: Procedure to elevate outer eye corner
Your surgeon will determine the best lower and upper eyelid-enhancing approach tailored to your goals. The incision lines are well-hidden within natural eyelid folds for invisible scarring. Temporary sutures or skin glue closes the incisions.
4 Lid Blepharoplasty Recovery Timeline
After 4 lid blepharoplasty, expect:
| Stage | Timeline | Recovery Experience |
| Swelling Peak | Day 1 – 3 | Swelling and bruising at their worst |
| Dressing Removal | Day 3 – 4 | Remove dressings and visible sutures |
| Bruising Fades | Week 1 – 2 | Bruising continues to fade, swelling decreasing |
| See Final Results | Week 6 | The swelling is gone, and you can appreciate enhanced eyes |
It takes patience through the early recovery swelling to appreciate your rejuvenated eyes. Most patients feel presentable in public 10 – 14 days after surgery. In 6 weeks, you’ll see your outcome with enhanced and visible eyelid platforms!
Activity Guidelines
Post op activity guidelines include:*
| Stage | Timeline | Allowed Activities |
| Rest & Recovery | Week 1 – 2 | Rest, relax, avoid salt, control swelling |
| Light Activity | Week 3 | Daily light activities like walking |
| More Activity | Week 4 | Computer work, reading, driving short distances |
| All Clear | Week 6 | Resume all activities and wear eye makeup/contacts |
Follow all of your surgeon’s recovery instructions diligently for proper, timely healing.
4 Lid Blepharoplasty Cost In Dubai
Like all cosmetic procedures, the cost depends on factors like:
| Factor | Details |
| Surgeon Expertise | Cost varies based on surgeon credentials and experience |
| Extensiveness of Correction | More complex corrections are more expensive |
| Location/Facility Fees | Prices differ based on clinic or hospital fees |
| Total Cost Range | 25,000 – 40,000 AED |
In Dubai, the cost of a 4-layer blepharoplasty can range between 25,000 – 40,000 AED. Your surgeon can provide an accurate quote after a personalised consultation examining your eyelids. Often, combining upper and lower blepharoplasty costs less than two separate surgeries.
Many Dubai plastic surgeons offer patient financing options to break the cost into more affordable monthly instalments. Some facilities also have in-house payment plans available.
Does Insurance cover 4 Lid Blepharoplasty?
Cosmetic eyelid surgery is not covered by health insurance. The exception is if you have documented functional visual field impairment from severe upper eyelid hooding. In this case, upper (not lower) blepharoplasty may be partly reimbursed.
Four eyelid blepharoplasty is a transformative anti-ageing procedure that rejuvenates the entire eye area. By removing excess upper and lower eyelid skin, reducing fat bulges, and tightening droopy muscles, both the upper and lower lids are aesthetically enhanced. Patients look more refreshed, alert and youthful after 4 lid blepharoplasty. If you are bothered by tired-looking eyes making you appear older than your years, comprehensive blepharoplasty could be a surgery to consider after thoughtful research. Choose an experienced oculofacial plastic surgeon to ensure the best cosmetic and functional outcome from your eyelid lift.
Dr. Tarek Bayazid is a highly experienced surgeon who specialises in blepharoplasty and innovative facial procedures. Book a consultation to learn if you are suited for solo upper or lower-lid surgery or comprehensive 4-lid blepharoplasty.
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