Looseness in the upper eyelids is due to either forehead laxity and/or upper eyelid skin laxity (dermatochalasis).
If the eyelid skin laxity is significant, then surgery to reduce the excess skin is appropriate.
Selective reduction of prominent fat in the inner portions of the upper eyelids can also be performed when appropriate.
Looseness of skin in the lower eyelids is similarly addressed by removal.
If needed, this may be combined with tightening or repositioning of the eyelid muscles, fat, or tendons in order to provide for maximal rejuvenation.
Via a similar approach a mid-cheek lift may also be performed if desired.