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Blepharoplasty can be performed on upper eyelids, lower eyelids, or both at the same time. Surgeon will make precise markings to designate where excess skin and fat pads need to be removed. Some underlying muscle may also be removed. On these markings, incisions are made in the natural folds of the eyelid, in the crease of the upper eyelid and just beneath the lashes or behind the lower eyelid. This way, incisions are virtually unnoticeable after they have healed. After making the incisions fat and muscle tissues are removed, surgical instruments such as scalpels, surgical scissors, radio-frequency cutting devices and sometimes cutting lasers. Once all the excess material is removed, sutures or tissue adhesives are applied carefully to smoothen the areas around the eyebrows and eyelids.

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