How Blepharoplasty is performed The procedure generally takes 1 to 3 hours under general anesthesia where incision is made along the natural skin lines or creases of the upper eyelids and below the lashes of the lower lids. If incisions is made from the inside surface of the lower eyelid (trans-conjunctival), it allows removal of lower eyelid fat without an externally-visible scar. However, it does not allow removal of excess skin.