The upper lids can appear droopy due to excess skin. This can be functional if it affects daily activities like reading and driving by compromising peripheral vision. Peripheral vision will be objectively measured with automated visual fields and by clinical exam. Insurance companies have a certain rubric that must be followed for approval.
The procedure entails using a CO2 laser to remove excess skin and perform tailored contouring to debulk the orbicularis muscle, brow fat pad, and/or remove orbital fat for an improved lid contour without changing the shape of the eyes.
This is usually performed under local anesthesia, so that lid symmetry can be evaluated intraoperatively. It usually takes about 30-45 minutes to perform. This can be done in conjunction with lower lid blepharoplasty or upper lid ptosis procedure as well and periocular or full face and neck laser skin resurfacing.