PURPOSE: To prospectively study patients' postoperative experience with blepharoplasty and to determine how closely patients' expectations compare with their actual experience. METHODS: A prospective observational study of 51 consecutive patients undergoing bilateral upper eyelid blepharoplasty by a single surgeon (J.A.L.) between October 2008 and May 2009 was performed. Prior to surgery, patients were asked to rate, on a scale of 1 to 10, their expectations of pain, swelling, bruising, blurred vision, impairment of ability to function in daily activities, and itching. Patients were then asked to rate these 6 elements at 7 time points: 30 minutes, 4 hours, 24 hours, 2 days, 3 days, 1 week, and 2 months. The number of pain pills utilized was also assessed. An analysis of the data was performed to determine our patients' experience with blepharoplasty surgery. The paired t test was used to determine the statistical significance of patients' expectations compared with their actual reported experience. RESULTS: In this cohort of patients, the authors found the following: blurred vision and impairment in ability to function peaked in the immediate postoperative period, pain peaked at 4 hours, swelling and bruising peaked at 24 hours, and itching peaked at 3 days. The mean number of narcotic pain pills used by patients in the postoperative period was 2.45. Patients underestimated the degree of swelling, blurred vision, and impairment in ability to function experienced following surgery. CONCLUSIONS: Postoperative patient experience with blepharoplasty is based largely on anecdotal evidence; the data from this study will facilitate more objectively based preoperative counseling.