There are two reasons for wishing to address upper eyelid problems, aesthetic, or functional. From a purely cosmetic standpoint, the brows may be positioned too low, or arch in a less feminine way, there may be upper lid skin excess and folding, leading to the prematurely aged, or chronic fatigue/ “always tired,” appearance. When the folding gets to the point of obstructing the patient’s field of vision, the procedure is done for functional, or reconstructive reasons. Typically, a patient must lose at least 30% of their total visual field owing to droopy brows and/or lid skin for insurance approval. Other medical reasons to have this done, include chronic irritation from skin folding with or without infection, or severe eye fatigue by the afternoon or evening, a night job, especially one requiring the operation of heavy machinery.