Blepharoplasty of the the upper eyelid rejuvenates the eyes, and the surgery is tailored to suit the needs of each patient. Excess skin is typically removed during upper eyelid surgery. A small amount of skin removal can dramatically improve one’s appearance and “open” the eyes, as the extra skin no longer covers the eyelashes.
Occasionally, excess fat is also removed. Fat removal was more common years ago, while modern facial plastic and cosmetic surgeons tend to preserve facial fat. Sometimes the eyelid muscle needs to be lifted too, especially for those with very droopy eyelids. An eyelid lift for upper eyelids which are hanging too low can improve vision on some patients.
Lastly, the specific technique on one eye may be different in the other eye due to inherent asymmetry present in most patients. Your eyelid plastic surgeon will help determine appropriate options for you.