In this paper we consider the flip operation for combinatorial pointed pseudo-triangulations where faces have size 3 or 4, so-called combinatorial 4-PPTs. We show that every combinatorial 4-PPT is stretchable to a geometric pseudo-triangulation, which in general is not the case if faces may have size larger than 4. Moreover, we prove that the flip graph of combinatorial 4-PPTs with triangular outer face is connected and has diameter O(n2).European Science FoundationAustrian Science FundMinisterio de Ciencia e InnovaciónJunta de Castilla y Leó