What happens to the eyelids to make them look aged?

This excess skin can occur above the eyes in the upper eyelids or below the eyes in the lower eyelids. Extra skin and puffy eyelids can be present simply from being born with a tendency to form baggy eyelids. Saggy, stretched skin can also form as part of the aging process. Medical conditions like sinusitis or recurrent allergies can cause repeated swelling and contraction around the eyes as well. As skin stretches and descends, extra tissue accumulates around the eyes. Furthermore, the firm tissue that normally holds back the natural fat pads around the eyes can also stretch. The weakening of this tissue allows the fat pockets around the eyes to bulge forward, causing puffy bags to form around the eyes in conjunction with the hanging, loose skin.

Blepharoplasty, or cosmetic eyelid surgery, directly addresses the hanging skin and bulgy bags around the eyes. It gives the eyelids a more youthful appearance, reduces eye fatigue, and can help with vision.