Upper and lower eyelid surgery is usually performed under general anesthetic. For the upper eyelid, an incision will be made along the natural crease of your upper eyelid, and the skin separated from the tissue. Excess fat and skin are then removed and the incision closed with sutures. For the lower eyelid, 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 sutures, which will need to be removed a few days later (unless dissolvable).