Asian upper blepharoplasty is one of the most popular cosmetic procedures for Asians, but less optimal result is still common. The authors’ comprehensive approach to Asian upper blepharoplasty includes (1) to determine both the height and length of the upper skin crease; (2) to create more ideal anatomy of the upper eyelid; (3) to reconstruct the desirable anatomic structure of the upper eyelid skin crease; and (4) to add a medial epicanthoplasty if needed to enhance cosmetic results.