Upper eyelid blepharoplasty is one of the most common facial plastic surgeries performed in the United States. Understanding how brow position contributes to the upper eyelid appearance is essential. Consistent and desirable surgical outcomes are best achieved with a detailed knowledge of periorbital anatomy. The surgeon must understand patients’ expectations and ensure that surgical goals are realistic. The potential complications and their management are discussed. The goal of upper eyelid blepharoplasty is to create a sculpted upper lid with a visible pretarsal strip and subtle fullness along the lateral upper lid–brow complex. The trend toward volume preservation is discussed.