Heavy upper lids read as tiredness even when you are rested, and they are one of the most common reasons people first consider facial surgery. The important question is where the heaviness is coming from.
Three sources, three different answers
There may be genuine redundant eyelid skin, which upper blepharoplasty addresses directly. There may be a brow that has descended and is bringing tissue down with it, which is a brow problem. Often it is some of both.
This distinction matters more than it sounds. If the brow has dropped and you remove upper lid skin, you can pull the brow lower still. The operation is performed correctly and the face looks worse.
Restraint ages better
The eyes reward taking less. Over-resection is what produces the hollow, skeletal look that people recognize as eyelid surgery from across a room, and it is very difficult to reverse.
Any consultation for heavy lids should include an assessment of brow position before a plan is made. If it does not, ask why.
