Lower eyelid surgery can be performed under local anesthesia, but since it can be more uncomfortable than upper eyelid surgery, it is also possible to perform it under general anesthesia. During this surgery, the procedure begins by making an incision just below the lower eyelash line or behind the eyelid. The fatty tissue that causes swelling is removed and, in some cases, the loose skin is tightened to achieve the desired appearance.

In lower eyelid surgeries, the support muscles in the eyelids may also need to be tightened, especially in patients with weak eyelids.