There are two types of anesthesia that can be administered, the first is local anesthesia with sedation and the second is general anesthesia. The best option will be discussed with you in order to offer the best possible comfort with the minimum risk.
The best option is to make it in the natural folds of your eyelids to make it as inconspicuous or less noticeable as possible. In your upper eyelid is performed on your natural fold, then you can remove surplus tissues of either skin, muscle or fat and address if there are functional problems such as the fall of it.
In the lower eyelid you can approach just below the line of your eyelashes or inside the eyelid through the conjunctiva. Removal or rearrangement of the fat deposits can be carried out but only if there is excess skin will the technique of the line of your lashes be performed.
The wounds are closed with generally non-absorbable sutures.