This 29 year-old gentleman was born with a droopy left upper eyelid. The appearance was not only very troubling cosmetically but caused significant tension headaches. This is very common in congenital eyelid ptosis; a condition which causes weak upper eyelid muscles to fatigue easily. He underwent a tightening of these muscles (known as a ptosis repair or tarsolevator advancement) and an upper blepharoplasty designed specifically to reinforce the Asian appearance of the eyelid. The postoperative result after 6 months shows significant improvement eyelid position as well as a more rested appearance. His headaches have also dissipated.