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The best way to determine if you need to consider blepharoplasty is simple: Look in the mirror.
• Do you look tired even though you aren't?
• Is the skin of your upper eyelid overhanging the normal lid crease and starting to impinge on the eyelashes?
• Are there bulges and bags where there shouldn't be?
• Do your eyes appear smaller than they did in years past?
If you're much over forty, chances are that some or all of the above signs may be present. Why? Because during your late thirties and early forties, the elasticity in the thin and delicate eyelid tissues starts to give out, even if the rest of your face still looks perfect (give or take).
Why else might you consider surgery? Are the above changes causing symptoms?
You may be able to feel an extra heaviness in the upper lid or feel its skin sitting on your lashes. To increase your peripheral vision, you need to lift up your forehead (causing all of those new and unsightly wrinkles). Your boss may call you in and start dropping hints about retirement just when you thought you were in line for a big promotion. Perhaps your father looked a lot like a Basset hound by the time he reached sixty and you really don't relish the idea of watching the same thing happen to you.
So, getting back to the question at the start -- how do I tell if I really need this? The answer shouldn't come as a surprise.
Most people never need to have a blepharoplasty. Signs and symptoms aside, baggy eyelids are simply not the same as cancer. The reason you undergo cosmetic eyelid surgery is because you WANT it.
Almost anyone past the age of forty can benefit from blepharoplasty, although the amount may vary greatly. What matters the most is how YOU feel about the changes you see in the mirror? If they don't really bother you, then let age take its toll.