The upper eyelids have a different anatomy than the lower eyelids, therefore, their correction is going to be different.

I believe that making the incisions accurately is the most important step. I design the incisions very carefully, and estimate the amount of skin and fat that needs to be removed from each side. Skin and fat are resected one side at a time in the same way. Symmetry of the eyelids is checked and the incisions are closed.

For the lower eyelid, I frequently perform the fat resection through the inside of the eyelid (transconjunctival incision). If there are significant wrinkles, then resurfacing is performed using either chemical peeling or with a laser. The groove between the lower eyelid and cheek can be filled with either fat or Restylane.