Lower eyelid surgery is usually performed under general anesthetic. An incision is made along the natural crease of your lower eyelid, just below the lower lashes, or on the inside of the eyelid. Excess fat or skin (or both) is then removed, or in some cases the extra fat is moved behind the muscle. The leftover skin is then pulled upwards, creating tension and a smooth effect. Finally the incision is closed with stitches, which will need to be removed a few days later (unless dissolvable).