The exposure of the levator aponeurosis during blepharoplasty allows the creation of a fixed, distinct lid crease and the opportunity for repair of any defect in the aponeurosis. The conventional blepharoplasty without deep fixation may show the scar separate from the crease and a tendency for early redundancy of skin low on the lid. Additionally, many elderly patients undergoing blepharoplasty have early separations in the levator aponeurosis. Repair of such defects may prophylactically defer the development of acquired ptosis or reverse an early unrecognized ptosis.