I have very heavy upper eyelids that have reached the point of covering my eyelashes...
Upper eyelid excess often contributes to obstructive vision if the excess extends to or below the lash line. Blepharoplasty is a commonly performed surgical procedure which will not only remove the excess skin and sometimes fat, but also will usually enhance the aesthetic appearance.
Excessive or 'redundant' upper eyelid skin is a very typical aging change that leads people to seek eyelid surgery. In many patients, this surgery can be performed under light sedation with local anesthesia as an outpatient office procedure. In a few cases, protruding fat behind the eyelids is also removed. As with most facial aging changes, no two people present with exactly the same eyelid concerns. Surgical treatment is therefore individualized to the needs of each individual patient.
My approach to upper eyelid surgery is to be conservative with skin excision, and to reserve excision of fat for patients with significant fat excess. In my opinion, aggressive removal of upper eyelid skin and fat is a 'skeletonizing' procedure which risks making eyes appear more deep-set and aged, rather than younger. In fact, in many patients I perform structural fat grafting (using the patient's own fat, from the abdomen or hips) to help restore soft tissue volume around the eyes.
Upper Eyelid Redundancy Effecting Vision – If you have redundant eyelid skin that goes over your lash line especially in the upper and outer quadrant then this may effect vision. Some insurance companies may cover this if there is a visual field quadrant defect. The upper blepharoplasty can then be done both for functional and aesthetic reasons.