The eyes are protected by the upper and lower eyelids, and if these lids are unattractive, the eyes are, too. While there are several things that can destroy their beauty, the most prevalent is probably the normal process of growing older of which heredity is an important factor. Keep in mind, though, sun damage and cigarette smoking are preventable causes of premature aging.

The upper eyelid has its own set of problems, different from that which afflicts the lower lids. As the skin becomes more elastic, the resultant sag can cause excess skin and fat to form into a hood over the lid. This gives the eye a tired, drooping look, and is further evidence of advancing age. In addition, the special cushioning fat pad can protrude here as well, creating an awkward bulge at the inner portion of the lid. A heavy-lidded look can also occur at an early age as an inherited trait.

An often unrealized problem is that the excess skin and fat can make the eyes look smaller than they should. One characteristic of fashion models is that most of these beautiful women have big eyes. By removing the excess skin and fat from the upper eyelids, the eyes appear to be bigger. This can make a dramatic change in your face without anyone realizing what you have done. These problems may be more than just cosmetically unattractive. The sheer weight of the extra skin can cause a person's eye to feel heavy or fatigued, especially at the end of a long day.

There can even be so much excess skin that it hangs down over the lid’s edge and obscures the patient’s field of vision. Some cases are severe enough that the individual has to tilt his head backward to see out from under his eyelids. It can also obscure vision out to the side. This condition is not only a sign of aging, but is medically undesirable and should be corrected as soon as possible.

The upper eyelids can be vastly improved through cosmetic surgery, using a procedure called upper blepharoplasty.

The Upper Eyelid -- This procedure is done by removing all of the overhanging skin through a small incision contained entirely within the upper eyelid crease. Fat that is contained above the crease is also removed. In some cases the surgeon will even excise a thin strip of muscle to create an even more distinct crease. If any of the cushioning fat pads bulge out, they are eliminated at the inner corner of the lid. Once all of the offending excess has been removed, the incision is carefully closed with very fine sutures.

There is no pain during the surgery and almost no one takes any pain pills afterward. The sutures are removed after three days. There is usually minimal black and blue and a little swelling. The resulting scar should be extremely thin and is generally imperceptible, because it will be hidden in the eyelid fold.

The risks are minimal. Infection is extemely rare. Very rarely a part of the scar thickens a bit and has to be redone. Another minor complication is the formation of tiny whitish cysts (called milia) at the margins of the incisions. But they normally vanish on their own; and if not, they can be easily removed in a matter of minutes.

The only serious risk is the possibility of surgical error, and the removal of too much eyelid skin is the primary concern. If this were to occur, you will not be able to close your eye completely. That could cause severe damage to the eye itself, especially if the cornea remains exposed during sleep. The problem may be impossible to correct. But this is not a true risk of the operation, since a good plastic surgeon would never allow this to happen; so you must be sure to find someone skilled in the procedure.

The benefit lasts a very long time, as it takes at least fifteen years for the hanging skin to return, and it will not be as bad as it was before the surgery.