If the surgeon does the procedure for both upper and lower eyelids, it usually takes about 2 hours. He/she injects a painkiller around the patient’s eyes to use local anesthesia and you are given oral sedation.
In the case of all four eyelids, the surgeons usually do the procedure on the upper lids first.
Anyway, in the first step, the surgeon cuts along the natural lines of the eyelids. Then, he separates the skin from the beneath through the cuts and removes the excess fat and skin. Now it turns that the surgeon closes the cuts. She /he does it with very small stitches. If there are stitches on the upper lids, they will stay for 3 to 6 days.
The lower lids may not need the stitches. It depends on the technique. The surgery on these eyelids is possible to be done by several techniques. One technique is that the surgeon makes a cut inside the lower eyelids to remove the excess fat. That cut is so small that you won’t see it. Then he/she will soften fine skin lines. He/she uses C02 or erbium laser to do that.
Another technique for blepharoplasty is that the surgeon makes a cut long margin of the eyelash. Then, he/she removes the excess skin, fat and slack muscle. The cut line won’t stay. It will fade in a short time.
If the surgeon does double eyelid surgery, he/she makes a crease in the upper eyelid to create wider and larger looking. This procedure is more popular in East Asia.
Some people have darker skin tones and external incisions usually leave a visible scar. A transconjunctival method that is a recent technological advancement is used typically for these people and is accepted norm. In this blepharoplasty method the surgeon cuts and removes lower eyelid adipose tissue in a way that no visible scar is left, but he/she does not remove excess eyelid skin.
Regardless of any technique, the last step may be the recommendation of laser resurfacing by the surgeon.