This procedure is done on an outpatient base under sedation and local or general anesthesia. If only surplus of fat is present in the lower lids, it may be removed through an incision inside the lower lids (trans-conjunctival approach). This technique does not involve an outer incision or scar, unless some excess skin needs to be removed as well.

When excess skin needs to be removed from lower eyelids, an incision is made just beneath the eyelashes. When excess skin needs to be removed from upper eyelids, the incisions are made where the natural fold should be in the upper lids. Extra fat and skin are removed.