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Before and after bilateral upper and lower lid blepharoplasty in a 46-year-old woman. She felt like she always looked tired, even after a good night’s sleep. Her parents had both had “their eyes done” due to drooping eyelids in their 70’s and 80’s. She wanted to improve the look of her eyes now, before her eyelid skin drooped so significantly that her visual fields might become obstructed.

When four eyelid lifts are performed at the same time, surgery is sometimes called a “quad bleph.” Patients can often stay awake for surgery, but when the lower eyelids are added to the upper lids, it is often easier for everyone for our patients to have a quick general anesthetic, so they are completely unaware of the surgery, and they are completely comfortable.

The last image shows surgical markings for a four-lid blepharoplasty. Only skin is removed – the underlying muscles and fat pads are left alone. The shape of the eye is not altered, and the results are normal and natural looking.

Follow up photos are shown 9 months after surgery.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton