As we get older, our skin slowly loses its elasticity. Genetics causes this, and to a lesser extent, environmental exposures. This skin loosening causes the skin to gather in both the upper and lower eyelids. Skin laxity on the lower eyelid causes wrinkles and redundancy. Fat accumulation and weakening of the eyelid muscles cause bulging. Muscle hypertrophy, laxity, and separation can also play a role in a less aesthetically pleasing eyelid. Eyelid surgery removes the skin, repositions or removes fat, can remove and or reposition muscle and can improve dark circles, or hollowing of the tear trough. Eyelid surgery can also recreate the natural fold in the upper eyelid. This can improve vision and the ability to apply makeup in the upper lid.