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Much better and closer up photographs are going to be required to make a determination about how best to proceed. The primary goal for upper eyelid surgery is to remove excess skin, and a small amount of puffiness on the inner corners. The primary goal for lower eyelid surgery is to remove fat bags, creating the puffy look on the lower lids with the incision on the inside of the eyelid itself. Ptosis repair is done if the eyelid muscles are weak.