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Technique · CPT 15823 + 15820

Quad blepharoplasty (upper + lower)

Upper and lower blepharoplasty performed together in a single surgical session, with a single anaesthesia and a single recovery period. Common for patients who have both hooded upper lids and lower-lid concerns.

Doç. Dr. Ayhan Işık Erdal
Doç. Dr. Ayhan Işık Erdal Associate Professor of Plastic Surgery
MD · FACS · FEBOPRAS · Associate Professor
✓ Medically reviewed · Last updated: May 18, 2026

When quad makes sense

Quad blepharoplasty makes sense when:

  • Both upper hooding and lower bags/skin laxity are present and bothering the patient
  • The patient is medically fit for a ~2-hour procedure
  • The recovery would overlap anyway — combining doesn't significantly extend the visible recovery period
  • The patient wants a single anaesthesia, single recovery, single travel trip (especially for international patients)

About 40% of our patients are candidates for quad. The other 60% have predominantly one-area concerns and benefit more from a single procedure.

What it involves

  • Anaesthesia: General anaesthesia is preferred for combined procedures — more comfortable for a 2-hour case.
  • Operating time: 90–120 minutes typically.
  • Lower lid approach: determined by lower-lid findings (transconjunctival or subciliary).
  • Order: upper first (typically) then lower.
  • Canthopexy: added if lower lid laxity suggests support is needed.

Combined recovery is not double recovery

One of the most useful things about quad blepharoplasty is that the recovery is essentially the same as a single procedure. The bruising and swelling timeline doesn't double. The visible recovery is ~14 days regardless of whether one or both lids were operated on.

What does change slightly:

  • Initial discomfort in the first 48 hours is a bit higher
  • Dry-eye symptoms in the first 2 weeks are more noticeable because both lids are involved
  • Lubrication routine needs to be more diligent

Frequently asked questions

How long should I stay in Istanbul for quad blepharoplasty?

Minimum 7 nights for international patients: arrival, pre-op assessment, surgery day, then 4–5 days of initial recovery before flying. Sutures come out at day 5–7. If you can stay 10 nights it's more comfortable.

Is the cost of quad just double a single procedure?

No — combined procedures save on anaesthesia, facility, and per-procedure overhead. Quad typically costs ~60–70% of what two separate procedures would cost in two visits.

Can I add other procedures to quad (rhinoplasty, brow lift)?

Quad + brow lift is a very common combination and the recoveries overlap well. Quad + rhinoplasty is possible but extends the operating time meaningfully — needs to be a deliberate choice with realistic expectations about the longer recovery. Beyond that (full facelift + quad + rhinoplasty in one session) we generally don't recommend — staging into 2 visits is safer.

Medical disclaimer: This page provides general information about blepharoplasty and reflects the clinical opinions of Doç. Dr. Erdal. It does not constitute medical advice for any individual patient. Results vary; all surgery carries risk. Blepharoplasty in some cases produces irreversible changes to eyelid anatomy. Suitability is determined only through personal consultation with full medical history disclosure.

Not sure if you're a candidate?

Blepharoplasty is most successful when patient anatomy, age, and goals align with what surgery can realistically deliver. Send three facial photos (front, profile, eyes-closed) and Doç. Dr. Erdal will give you an honest, no-pressure suitability assessment before you commit to anything.

Ready to discuss your case?

Doç. Dr. Erdal personally reviews every enquiry. Honest assessment of whether blepharoplasty is right for you, with no pressure to book.

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