Blepharoplasty or eyelid surgery is the removal of loose or lax upper or lower eyelid skin and or repositioning of skin and fat to correct aesthetic concerns of the upper and lower eyelid. The upper lid blepharoplasty can be performed as an in-office procedure under local anesthesia if desired. It is a very easy, simple, and straightforward procedure that results in a rejuvenation of the appearance of the upper eyelid. The results are long-lasting, up to 10 years or longer. Lower lid blepharoplasty is a little trickier. The procedure is almost like a mid-face lift. The lower lid skin as well as the tear trough deformity and pouching or festooning of the lower lid and cheek skin can be corrected. The recovery is longer sometimes taking several months versus several weeks for the upper lid procedure. There is also a risk of lower lid scarring known as ectropion which can take time to resolve and can result in a pulling down of the lower lid skin. Both procedures are very effective in the rejuvenation of the eyes. It is recommended that the lower lid procedure be done under anesthesia versus local only in the office. In general patients have high satisfaction from these procedures.