Although blepharoplasty is conceptually an easy surgery - take out skin and excess tissue - many surgeons ignore the meticulous details that are crucial to a beautiful outcome.
Placement of the incision line is not difficult if the surgeon knows what they are doing. Unfortunately, there are many surgeons who are not trained adequately to do this delicate surgery.
In practice, the incision for an upper blepharoplasty is located directly in the eyelid crease, which is generally 6 - 8 mm above the lid margin. The upper eyelid incision is typically marked with the patient awake so they can open and close their eyes and the surgeon can determine if the marks are in the correct spot to have the incision be hidden well in the fold and make sure the correct amount of skin is being removed.
It is important to find a surgeon who is experienced. He/she will be able to show you before and after photos of their own work and show you where the upper eyelid incision should be placed. An upper blepharoplasty is simple for someone with experience, but it takes years of experience to get there.
When the upper blepharoplasty is performed by an experienced and talented surgeon, the final scar should be rather imperceptible.
Upper blepharoplasty incisions, when properly constructed, should blend into the preexisting eyelid crease and become invisible rapidly during the postoperative period. The lateral extent of the incision is exposed to the sunlight, and to the public, and needs to be cared for to produce optimum results. By far the most common result is that this incision becomes invisible (or visible only with a 10x magnifying mirror!) without a few months.
Proper care of the incision includes avoiding UV light. A silicone scar treatment is also quite helpful.