This chapter discusses cosmetic upper eyelid blepharoplasty, where modern upper blepharoplasty eventually evolved into a procedure founded on the graded excision of variable degrees of skin, muscle and fat. The brows and upper lids in youth are full without obvious depressions or contour irregularities. The loss of brow volume with unopposed depression of the outer brow allows the tail of the brow to descend and leads to classic hooding of the temporal upper lid. The nasal fat pad, which is in direct continuity with orbital fat, is stem cell rich, whereas the central fat, which is separated from the orbit by the levator aponeurosis, is relatively progenitor cell deficient. In the superonasal brow–upper lid transition, the hollow has been referred to as the orbitoglabellar groove, named relative to its adjacent anatomy. The second segment of the orbicularis muscle is called the palpebral component as it overlies the eyelid proper. The central fat is called the preaponeurotic fat, as it overlies the levator aponeurosis. The accessory upper eyelid retractor is Mueller’s muscle.