Many patients come in saying, “I am not sure if I need my upper lids, my lower lids, or both.” They just know their eyes look more tired or aged than they feel. In some cases, treating only the upper or only the lower lids is enough. For others, like the patient in these photos, combining upper and lower blepharoplasty creates a more complete and balanced transformation.
In her before photo, you can see both heavy upper eyelid skin and noticeable under eye bags. In the after photo, her upper lids are cleaner and more open, and her lower lids are smoother and less puffy. She looks dramatically refreshed, but still like herself.
When focusing on only upper or lower eyelid surgery can feel incomplete
Dr. Sabet-Peyman will let you know if you are a good candidate for upper and lower eyelid blepharoplasty. Not every patient needs to have both done but patients that neglect to address the other half of the surgery and who need it may be left wondering why they didn’t do it all. If only one part is treated, the untreated portion can stand out more afterward.
Examples:
- Correcting only upper lids can make under eye bags look more obvious by comparison.
- Treating only lower lids can leave heavy upper skin that still crowds the eyes
Patients sometimes describe this as feeling “half finished” or “like something is still off.” For people with both upper hooding and lower bags, like this patient, addressing all four lids in one surgery often gives a more harmonious and complete result.
How combining upper and lower eyelid surgery produces a complete result
When Dr. Jason Sabet Peyman plans upper and lower blepharoplasty together, he can design the entire eye area with one cohesive goal:
- Upper lids: Remove or reshape excess skin and, when needed, a small amount of fat to reveal the natural crease and lighten the heaviness over the lashes.
- Lower lids: Reduce or reposition the fat pads that create under eye bags, smooth the lid cheek transition, and, when appropriate, tighten or refine the skin.
Done together, these changes:
- Make the eyes more vibrant
- Soften the tired or stern look from both above and below
- Create a cleaner, more continuous contour from brow to cheek
This patient was happy because she decided to do it all together. She probably would have had to have another surgery if she only did the uppers or lowers alone.
One surgery and one recovery window
Another advantage of combining upper and lower eyelid surgery is efficiency:
- One procedure in the office instead of two
- One healing period, with swelling and bruising resolving over a similar timeline for both lids
- One block of time off work, rather than needing two
Most patients see the bulk of swelling and bruising improve over one to two weeks, with more subtle refinements continuing over the next few weeks. Recovering from both procedures at once is often simpler than going through the same process two different times.
Is combining procedures more expensive?
A combined surgery is a bigger investment than treating just the upper or just the lower lids alone, but it is usually more cost effective than doing two separate procedures.
Dr. Jason Sabet Peyman performs eyelid surgery in his own Fullerton office under local anesthesia. This is a savings compared with the cost of doing surgery at a surgery center. Your total cost mainly reflects:
- Whether you treat upper lids, lower lids, or both
- The complexity of your anatomy
- Whether other treatments are combined, such as laser resurfacing or ptosis repair
During your consultation, you will receive a personalized treatment plan with a clear written quote for each option, upper only, lower only, or both, so you can decide what feels right for you without any surprises.
When just upper or just lower blepharoplasty still makes sense
Not everyone needs surgery on all four lids. In some situations, Dr. Sabet Peyman may recommend a more limited approach, such as:
- Upper blepharoplasty only for patients whose main concern is heavy, hooded upper lids, sometimes affecting vision or makeup.
- Lower blepharoplasty only for patients with strong under eye bags but relatively good upper lid skin.
His goal is always to recommend the smallest procedure that will meaningfully address what bothers you, while still keeping the overall eye area in balance.
Upper and lower eyelid surgery in Fullerton and Orange County
If you have been debating between upper, lower, or both, you do not have to figure it out on your own. That decision is exactly what a detailed eyelid consultation is for.
Dr. Jason Sabet Peyman is a fellowship trained oculofacial plastic surgeon who focuses exclusively on eyelid and periocular surgery. From his office in Fullerton, he performs upper blepharoplasty, lower blepharoplasty, and combined four lid eyelid surgery for patients across Orange County, including Fullerton, Newport Beach, Laguna Beach, Irvine, Yorba Linda, and Huntington Beach.
If you see some of your own concerns in this patient’s before photo, heavy upper lids, under eye bags, or both, a consultation with Dr. Sabet Peyman can help you understand whether upper, lower, or combined eyelid surgery will give you the most natural and complete refresh.
