Some patients have excess eyelid fat, tough skin, and overly hypertrophied upper lids, commonly referred to as “puffy eyes”. The common features of these patients are a narrow eye slit and a hypertrophied, swollen upper eyelid, giving the patient a feeling of depression. For these patients, blepharoplasty can be used to remove some of the fat from the eyelids and thin the eyelids. There are 4 main fat zones in the eyelid in the Oriental eye shape, 3 of which are important in blepharoplasty: the subcutaneous fat layer, the orbital septum fat layer, the anterior blepharoplasty fat layer, and the inframuscular fat layer. In patients with “puffy eyes”, the inframuscular fat layer is more prominent, making the outside of the lid more bulky. Removal of this layer is important in blepharoplasty. Blepharoplasty, also known as double eyelid surgery, is one of the most common procedures performed in cosmetic surgery. For different candidates, the procedure is broadly categorized as incision, threading, etc. However, regardless of the procedure, the basic principle is to adhere the eyelid skin to the levator muscle or the levator plate, so that the upper eyelid skin can be depressed to form a blepharoplasty crease when the eyes are opened. The incision method is suitable for almost all candidates, and candidates with thick upper eyelids can choose this method.