The excess skin on her upper eyelids was so heavy that it was pushing her lids down to cover her pupils.  Note that in the after picture, we can see much more of the iris, the colored part of the eye.

Also, in the before picture we can't see any of the crease that normally resides about one-fourth of an inch above the eyelashes.  That crease provides a perfect place to hide the incision for this operation.