Excess skin on the upper eyelid is known as dermatochalasis. Depending on the extent of laxity, there are several ways that this can be addressed. Mild skin laxity is amenable to non-invasive procedures such as laser treatments or radiofrequency. For moderate to large amounts, especially with lateral hooding or drooping, surgical excision is required. This can be done via the upper eyelid crease, or by a sub-brow/infra-brow blepharoplasty.
If only skin needs to be addressed and in large amounts, the sub-brow/infra-brow approach just below the eyebrow will enable skin removal while maintaining the natural upper eyelid crease and fold. The scar, if sutured and managed well, is usually not obvious at all.
However, if concurrent procedures such as muscle tightening need to be addressed, the upper eyelid crease incisional blepharoplasty approach provides the best access. The only issue is that if large amounts of skin are removed through this approach, the fold may appear unnatural due to the overhang of the thicker superior skin over the thinner inferior skin. Have a discussion with your plastic surgeon and explore the various options before deciding on the management plan together.