In order to avoid scars the upper lid incision is strictly in a natural crease, the lower eyelid is whenever possible treated through the conjunctiva which leaves no external scar. Fat is not removed but repositioned.
The anaesthesia will be local with light sedation if required. After shortest possible incision the excess skin of the upper eyelid is removed, muscle and fat are corrected and the closure is with a very fine suture. The lower eyelid will in most cases be treated through the conjunctiva, which requires no suture and no external scar. If skin has to be removed it will be through an imperceptible subciliary incision, and more often some undermining will suffice. The stitches are removed after 3 days, most bruising subsides within 2 weeks.