There are many characteristic features of the Asian eyelid that differ significantly from those of the Occidental. The most noticeable of these are fullness of the upper eyelid and a low or absent upper lid crease. The patient may desire the preservation of these distinctive features during ptosis surgery. The surgical techniques of ptosis repair and the preservation of the typical Asian eyelid features during ptosis repair have not previously been described in the literature. This study describes the histologic differences between the Asian and Occidental upper eyelid, and the application of this anatomic knowledge to surgical techniques of ptosis repair with special emphasis on the preservation of the Asian eyelid features.