What is a Quad Blepharoplasty?

What is a Quad Blepharoplasty?

Have you ever found yourself gazing into the mirror upon waking and pondering, “When did the appearance of under-eye bags and drooping eyelids become so pronounced?Quad blepharoplasty may serve as the solution you seek. This technical term refers to a surgical procedure aimed at rejuvenating both your upper and lower eyelids, aligning your external appearance more closely with the vibrant, alert individual you feel like internally.

Quad blepharoplasty focuses on enhancing both your vision and the way you are perceived by others. Envision no longer appearing perpetually fatigued or coping with visual impairments due to sagging eyelids. This is the essence of a quad blepharoplasty. It is not about altering your identity but rather about providing the necessary care for your eyes to ensure you can continue to lead your best life, free from visual hindrances. In this blog, Consultant Plastic Surgeon Anthony MacQuillan will discuss the details of quad blepharoplasty.

Upper vs. Lower Blepharoplasty: What’s the Difference?

Imagine your eyelids are like curtains—sometimes they need a little adjustment to really let the light in. That’s where the eyelid lift, or blepharoplasty, comes into play. Here are what each type of procedure entails:

  • Upper Eyelid Lift: Over time, your upper eyelids might start to sag which can make you look more tired than you feel or even mess with your vision. During an upper eyelid tune-up, Anthony trims away the extra skin (and maybe a little fat) that’s causing the sag, giving you a more awake and open look
  • Lower Eyelid Lift: This area often gets baggy or puffy, making you look tired. The lower eyelid lift targets these bags, removing or repositioning fat and tightening the skin to smooth out the area

When you opt for quad blepharoplasty you’re giving both the upper and lower eyelids a complete overhaul.

Who Needs A Quad Blepharoplasty?

Observing your reflection and wondering why the person staring back appears perpetually weary may be a common experience for you. If this is a familiar concern, a quad blepharoplasty could very well be the solution you’ve been seeking. This procedure is not exclusively for individuals advancing in age who are observing the effects of gravity. Rather, it is equally applicable to the younger demographic who, due to genetic factors, experience eyelids that sag.

You’re a good candidate for a quad blepharoplasty:

  • If your upper eyelids are droopy and affecting your line of sight
  • If you have bags under the eyes that are getting more and more difficult to hide with concealer
  • If you’re healthy, have realistic expectations and can quit smoking for a few weeks before and after the surgery

Quad Blepharoplasty – What Does the Process Entail?

Here’s an overview of the process of getting a quad blepharoplasty:

Consultation and Planning

The journey begins with a detailed consultation, where Anthony evaluates your facial structure, skin quality, and eye health. During this stage, Anthony discusses your goals and expectations, explaining the potential outcomes and any risks involved. This preparatory step is important for tailoring the procedure to the individual’s specific needs, ensuring a natural and harmonious result.

The Surgical Procedure

Quad blepharoplasty is performed under local anaesthesia with sedation, allowing you to be comfortable and pain-free throughout the process. The entire procedure can take between two to three hours, depending on the complexity and the extent of the corrections needed.

  • Upper Eyelids: Anthony makes precise incisions along the natural crease of the upper eyelids to minimise visible scarring. Through these incisions, excess skin and fat are removed or repositioned to create a more alert and youthful appearance. The muscles may also be tightened as needed.
  • Lower Eyelids: For the lower eyelids, incisions are usually made just below the lash line or inside the eyelid (transconjunctival approach) to remove or redistribute excess fat. This technique helps in reducing puffiness and bags under the eyes. If there’s excess skin, it’s carefully trimmed to smooth out wrinkles and tighten the area, enhancing the overall shape and contour of the eyes.
  • Closing the Incisions: Once the necessary adjustments are made, Anthony meticulously closes the incisions with fine sutures, ensuring the scars will be as inconspicuous as possible. In some cases, self-absorbing sutures are used, which do not require removal and dissolve on their own.

Post-operative Care and Recovery

Following the surgery, you are provided with detailed care instructions to ensure a smooth and effective healing process. This includes guidelines on how to manage swelling and bruising, medications for pain and infection prevention, and advice on when to resume normal activities. The first follow-up visit is typically scheduled within a week after surgery to assess the healing progress and remove any sutures if necessary.

Recovery times vary, but most patients can return to work and light activities within a week or two, with more strenuous activities gradually resumed as healing progresses. The final results of the surgery will become more apparent as swelling subsides over the following weeks and months, revealing a more refreshed and rejuvenated appearance.

Possible Complications Associated with a Quad Blepharoplasty

As with any surgical procedure, there are potential side effects that you should be aware of before making a decision:

Common Side Effects

  • Swelling and Bruising: The most common aftermath, swelling, and bruising can last from a few days to several weeks, varying from person to person.
  • Dry Eyes: Many patients experience dryness in their eyes post-surgery, which usually resolves within a few weeks. Eye drops or ointments can help alleviate this discomfort.
  • Temporary Vision Changes: Blurred or double vision may occur shortly after the procedure but typically resolves within a few days.
  • Sensitivity to Light: A heightened sensitivity to light can be expected, making sunglasses a temporary best friend for outdoor activities.

Less Common Side Effects

  • Infection and Bleeding: Though rare, any surgery carries the risk of infection and bleeding. Following post-operative care instructions can minimise these risks.
  • Scarring: While scars from the incisions are usually well-concealed, they can sometimes be more noticeable than expected.
  • Asymmetry: There is a risk that the eyes may not look symmetrical after the swelling has subsided, although minor adjustments can often correct this.
  • Difficulty Closing Eyes: In some cases, you may find it hard to fully close their eyelids after surgery. This condition is usually temporary but can be permanent in rare cases.

Serious Complications

  • Loss of Vision: An extremely rare complication, but loss of vision can occur due to injury to the eye or optic nerve during surgery.
  • Ectropion: This condition, where the lower eyelid turns outward, is rare but may require further surgery to correct.

Recovery after a Quad Blepharoplasty

Here’s advice on making your recovery process smooth:

  • Use ice: Gently applying ice packs during the first 48 hours can reduce swelling.
  • Get enough rest: Elevate your head with a couple of extra pillows to help reduce swelling.
  • Wear sunglasses: Your eyes will be sensitive to light, so make sure to wear your sunglasses everywhere.
  • Avoid screens: Give your eyes a break from screens to avoid straining them. Now’s the time to catch up on your podcast or audiobook backlog.
  • Use your prescribed eye drops. Dry eyes are a common side effect, so keep them lubricated.
  • Don’t rub your eyes. No matter how itchy they feel, resist the urge.
  • Don’t engage in strenuous activities. Put your gym membership on pause and avoid bending over or lifting heavy objects.
  • Don’t smoke. Smoking hampers the healing process, so consider this a good opportunity to quit or take a break.

Expect to take it easy for a week or two before you start feeling like yourself again. Most people can return to work within 10-14 days, but remember, healing is a personal journey.

FAQs about a Quad Blepharoplasty

What can I expect in terms of recovery time after a Quad Blepharoplasty?

  • You should anticipate a recovery period of approximately 10 to 14 days for the most noticeable swelling and bruising to subside. It’s important to follow Anthony’s post-operative instructions carefully, including attending follow-up appointments and avoiding strenuous activities. Full recovery and the final results may take several weeks to months as your eyelids continue to heal and settle.

How do I know if I am a good candidate for Quad Blepharoplasty?

  • Ideal candidates for Quad Blepharoplasty are individuals experiencing functional issues, such as impaired vision due to droopy upper eyelids, or cosmetic concerns, including under-eye bags and wrinkles. You should be in good overall health, a non-smoker, or willing to quit, and have realistic expectations about the surgery’s outcomes. A consultation with an experienced plastic surgeon will determine your suitability for this procedure.

Are the results of a Quad Blepharoplasty permanent?

  • While a Quad Blepharoplasty offers long-lasting results, it’s important to remember that the natural ageing process continues. Factors such as genetics, lifestyle, and sun exposure can influence the longevity of your results. Most patients find their outcomes to be satisfying and enjoy a rejuvenated appearance for many years.

What are the risks associated with a Quad Blepharoplasty?

  • As with any surgical procedure, a Quad Blepharoplasty carries certain risks, including infection, bleeding, dry eyes, temporary blurred or impaired vision, and the need for revision surgery. Choosing a skilled and experienced surgeon minimises these risks significantly. Discussing your medical history and closely following Anthony’s advice can further ensure a safe and successful outcome.

How should I prepare for a Quad Blepharoplasty?

  • Preparation for a Quad Blepharoplasty includes undergoing a comprehensive medical evaluation, adjusting current medications as advised by Anthony, and avoiding medications that can increase bleeding, such as aspirin and anti-inflammatory drugs. It’s also recommended to stop smoking well in advance of the surgery to promote better healing. Ensuring you have a support system for the recovery period, including help at home and time off work, will contribute to a smoother post-operative experience.

Further Reading about Blepharoplasty with Consultant Plastic Surgeon Anthony MacQuillan

Medical References about Blepharoplasty