Four-Lid Blepharoplasty
Combined upper and lower eyelid surgery in one session — the most complete periorbital rejuvenation when both lids need treatment.
Medically reviewed by Mark S. Brown, MDOculoplastic SurgeonLast updated June 2026
Part of our complete guide to Blepharoplasty (Eyelid Surgery) — this page covers four-lid blepharoplasty in depth.
Four-Lid Blepharoplasty (Combined Upper & Lower)
Four-lid blepharoplasty treats both upper and lower eyelids — all four lids — in a single operative session. When both excess upper-lid skin and lower-lid fat herniation are significant, combining the procedures can provide comprehensive periorbital rejuvenation in appropriately selected patients while sparing the patient a second anesthetic and a second recovery.
Is It Right for You?
A combined approach makes sense when:
- Hooded or heavy upper lids coexist with puffy lower-lid bags
- You want to balance the upper and lower lids in one result rather than staging them
- You are healthy enough for a slightly longer (still outpatient) procedure
Each lid is addressed with its own technique — a hidden crease incision above (see Upper Eyelid Blepharoplasty) and a transconjunctival or sub-ciliary approach below (see Lower Eyelid Blepharoplasty) — combined into one plan.
The Combined Procedure
Ready to discuss Four-Lid Blepharoplasty?
Schedule a consultation with Mark S. Brown, MD to learn if this procedure is right for you.
