Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, your surgeon will probably work on the upper lids first, then the lower ones. In a typical procedure, incisions are made 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.

Underlying fat, along with excess skin
and muscle, can be removed during the
operation.

If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, Dr Lista may perform a transconjunctival blepharoplasty. In this procedure an incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger Toronto, Ontario eyelid surgery patients with thicker, more elastic skin.

In a transconjunctival blepharoplasty, a tiny incision is made inside the lower eyelid and fat is removed with fine forceps. No skin is removed, and the incision is closed with dissolving sutures.

In order to achieve the best possible result, some patients require additional procedures to be performed at the same time as their eyelid surgery. Very wrinkly skin of the eyelids and wrinkles in the crows-feet area may require lasering of the lower eyelid skin.  Some patients with very droopy upper eyelids may have a problem with droopy eyebrows. If the droopiness of the upper eyelid is due to sagging of the eyebrow, then a brow lift may be necessary. A brow lift or lasering of the skin may be performed at the same time as an eyelid lift if necessary. Newer techniques, such as endoscopic brow lift, allow this procedure to be performed with minimal incisions..