Aesthetic surgery to achieve a younger, more wide-awake look around the eyes is probably the most common type of operation for middle-aged patients. Sometimes younger
patients also want to do something about a tired, swollen look around their eyes.

There are some hereditary characteristics that provide sufficient motivation for such an operation on young people as well – often excess fat “genetically stored” below the lower eyelid or even the upper one. Usually, however, the first signs of aging become apparent when we reach our 30s or 40s, and usually just around the eyes.
The aging process brings changes in the skin, which loses
its elasticity and consequently begins to stretch and sag. This loss of elasticity allows the fat around the eye to begin protruding, resulting in bulges around the eye that can almost be regarded as small “fat hernias”. The growing excess of skin on the forehead and the increasing droop of the eyebrows also have an effect on the appearance of the upper eyelid.
As mentioned earlier, cosmetic surgery to make people look younger was performed very early in this century. Various methods were developed for removing the surplus skin from the upper and lower eyelids. Most of them simply removed skin, which all too often meant the shape of the eye itself was altered and the patient had problems after the operation.
Since then the techniques have been refined, and in recent years the trend has been to remove less and less skin. More effort is put into achieving the desired effect by instead modifying the underlying muscles and removing or repositioning the fat in the eyelids. The goal with the upper eyelid is to enhance the supraorbital crease, which gives a more open, alert look.