is there more risks or complications when having the upper and lower eyelids done at the same time?

Is there less risks and complications when having only the upper or lower eyelids surgery than having both upper and lower done at the same time?

Doctor Answers 8

Upper and lower eyelid surgery

There's no added risks associated doing both upper and lower eyelid surgery at the same time. Any anesthetic risks are less because there is only one anesthesia for both procedures, rather the two anesthetics for two procedures.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

The four lid surgery may be a more difficult recovery

Hello Libbra,

You may experience more discomfort and swelling with surgery on all four lids.  I believe the incidence of dry eyes (hopefully just temporary) is also higher.  Generally, risks and complications are the same when two eyelids versus four eyelids are treated.  The advantage is one downtime.  All the best to you in your recovery.

D`Arcy Honeycutt, MD
Bismarck Plastic Surgeon
4.7 out of 5 stars 22 reviews

Are the risks and complications get higher in 4 eyelids operated at the same time?

Complications and risks are the same whether you have 2 eyelids or 4 eyelids together because upper and lower eyelids are separate units. Having both lids together if you need both corrected will be the best option as you'll get the anesthesia once. For years I've been performing laser eyelid surgeries which reduces some of the risks and complications compared to classical surgery and easily performed under local anesthesia, especially helps getting muscular laxity corrected easier and better than classical surgery without resection of the muscle in upper eyelid and removing the fat deposits in lower eyelid by vaporization - that'll also reduce the trauma during surgery, very less bleeding and recovery will be a lot much quicker than classical. However even with classical surgeries, I always advise to have both together if there is a need of doing all.

Kind Regards,

Dr. Turker Ozyigit


Turker Ozyigit, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 1 review

Complications Upper vs Upper and lower lids

Thank you for your question. Generally the complication rate is maybe slightly higher for the procedure on the lower lids as it is slightly more invasive, but my patients prefer to have both done because it is one downtime versus two separate surgeries. So no, I'd say there is not more risk when having both done at the same time because it saves you from undergoing anesthesia a second time.

Best wishes,

Benjamin J. Cousins MD

Benjamin J. Cousins, MD
Miami Beach Plastic Surgeon
5.0 out of 5 stars 10 reviews

Is there more risks or complications when having the upper and lower eyelids done at the same time?

Hello Libbra - Thanks for your question. As long as you are healthy, don't have a bleeding disorder, have normal/low blood pressure during surgery, and your surgeon is extremely experienced in eyelid (blepharoplasty) surgery, it won't matter if you have all 4 lids done at the same time vs. doing upper and lower eyelid surgery separately. The advantage to having all 4 lids done at the same time is that you have one recovery vs. 2 separate surgical recoveries. I would recommend that you consult with an eyelid surgery specialist in your area for more information. 

Good luck, 

Dr. Shah 

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 55 reviews

2 lid vs 4 lid surgery

There would not be much different in risk or complications doing all 4 at the same time.  Most people prefer this as they only have to have one downtime.  You will usually get more swollen and bruised when doing the lower lids and that will be true if you do those alone or with the upper.  The complications such as ectropion are going to be the same either way.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Risks associated with upper and lower eyelid surgery

I do not believe there is a significant additional risk to combining the two procedures compared to having each procedure separately . While there may be a little more swelling  or delayed healing for the combined procedure in the short-term, undergoing surgery twice, as two separate episodes, instead carries its own additional risk 

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 198 reviews

Complications of upper and lower eyelid surgery

This is a great question. When eyelid surgery is done by an experienced surgeon, the risk of complications is very low. In general, lower eyelid surgery has a higher rate of complications that upper eyelid surgery. The main goal of upper eyelid surgery is usually to remove excess skin. This is less invasive than lower eyelid surgery, which usually involves removing fatty tissue . Excess bleeding is more common when fat is removed. Again, in experienced hands, the rate of complications for both upper and lower eyelid surgery is really low.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 164 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.