Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, Dr. Chivers will probably work on the upper lids first, then the lower ones. This is an outpatient procedure, so you'll be able to return home on the day of your surgery, though you will need someone to drive you.
Upper eyelid surgery is usually performed under local anesthesia, which numbs the area around your eyes, along with oral sedatives if desired. You'll be awake during the surgery, but relaxed and insensitive to pain. (However, you may feel some tugging or occasional discomfort.) If Dr. Chivers decides to use general anesthesia, you'll sleep through the operation.
In a typical procedure, incisions are made following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through these incisions, Dr. Chivers will separate the skin from the underlying fatty tissue and muscle. Excess fat will be removed, and any sagging skin and muscle will be trimmed away. The incisions are then closed with very fine sutures. If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, transconjunctival blepharoplasty may be an option. In this procedure, the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.