In this the surgeon makes an incision along the natural fold of the upper eyelid first. When removing fatty tissue, the surgeon may carry out a transconjunctival blepharoplasty with an incision inside the lower rim of the eye's skin. Then the excess skin, some muscle and fat beneath the skin is removed. After the surgery the incision is closed with stitches (that can leave invisible marks) and surgical tapes.
The incision on the lower lid is performed below the eyelashes or inside the lower lid. In this also the surgeon removes the excess fat, muscle and flabby skin.
f your eyelid hangs down close to your pupil, blepharoplasty is done in combination with another method to deal with that problem, which is called Ptosis (TOE-sis).