Blepharoplasty usually takes one to three hours, depending on the extent of the surgery.  If you’re having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones.
            In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids.  The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes.   Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle.   The incisions are then closed with very fine sutures.
            If you have a pocket of fat beneath your lower eyelids but don’t need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty.  In this procedure the incision is made inside your lower eyelid, leaving no visible scar.  It is usually performed on younger patients with thick, more elastic skin.

Types of anesthesia

Eyelid surgery is usually performed under local anesthesia-which numbs the area around your eyes-along with oral or intravenous sedatives.   You’ll be awake during the surgery, but relaxed and insensitive to pain.   (However, you may feel some tugging or occasional discomfort.)  Some surgeons prefer to use general anesthesia;  in that case, you’ll sleep through the operation.

If you’re considering eyelid surgery…
The best candidates for eyelid surgery
All surgery carries some uncertainty and risk
Planning your surgery
Preparing for your surgery
The surgery
After your surgery
Getting back to normal
Your new look

Eyelid Surgery Patients Before and After Pictures