Folding of lids is a geneticaly caused varient of the aging process. It gives a tired and bored look to people and affect interpersonal relationships. I prefer using general anestehesia for lower lid while local anesthesia and sedatives are adequate for the upper lid. I mark skin incisions in the standing patient while keeping the incision right under ciliary line in the lower lid and deepest line in the upper lid. If necessary I take clues from former photos. After surgery swelling and bruising stay for 4 to 7 days. Using sun glasses is a simple soution to this problem. A younger and a healthier look is easliy achived after this procedure so it is one of the leading procedures the I advise.