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8%). Clinical effectiveness was satisfactory in most of the patients (104/112, 92.9%). Only 5 patients (4.5%) expressed subjective dissatisfaction with postoperative outcomes; of these, 3 patients complained of eyelids asymmetry (2.7%). Two patients complained of eyelids scar formation (1.7%); Whereas surgical revision was required in only 1 patient (0.8%). The reverse orbicularis-tarsus fixation technique for upper eyelid blepharoplasty is safe and effective, with better biomechanics and a satisfying aesthetic outcome.