Just underneath the eye lashes of the lower eyelid an incision is made through the skin and the underlying muscle, after which some of the excess fat can be removed. Where necessary some skin can be removed. The scar just under the eyelashes is hardly visible. Because the removal of fat can be a bit painful, I prefer to perform this procedure under, short, general anesthetic, however, local anesthetic is also a possibility.
In case only fat (a small amount) needs to be removed than this can be done via an incision in the inside of the eyelid, the so called transconjunctival incision. This technique has two advantages: a) There is no scar at all, not even the small scar under the eyelashes., b) The muscle around the eye is untouched which has long term advantages for the function of the lower eyelid.
If mainly excessive skin needs to be removed, than the procedure is as follows: The skin will be loosened from the underlying muscle through an incision just under the eyelashes of the lower eyelid. The skin will be partially removed and tightened. The muscle remains untouched.
The operating time for a lower eyelid correction is one hour.