Introduction: To describe surgical techniques of blepharoptosis treatment during upper eyelid cosmetic blepharoplasty. Materials and Methods: All patients underwent a preoperative evaluation, including eyelid position measurements, visual field testing, and, where appropriate, phenylephrine testing. Standard upper eyelid blepharoplasty skin/orbicularis excision was performed, exposing the orbital septum. External levator repair was then performed through an 8-mm incision in the orbital septum. In other patients, internal ptosis repair was performed transconjunctivally following upper eyelid blepharoplasty. Results: Ptosis repair methodologies of internal versus external approaches are compared and contrasted. Discussion: Combining ptosis repair with cosmetic blepharoplasty is a safe, effective treatment for patients who demonstrate both dermatochalasis and ptosis.