In Dr Birch’s hands, no blepharoplasty is the same. Each patients eyelids have unique problems that need to be addressed whether that be excess skin, excess fat, stretched muscles or asymmetry. A careful preoperative consultation will determine what exactly needs to be done. The resultant effect is a much ‘fresher’ appearance with hidden, well-placed scars. This is a technical operation that should only be trusted in someone experienced in facial surgery.