The purpose of this study was to describe surgical techniques and results of upper blepharoplasty for dermatochalasis to optimize cosmetic outcome in males, compared with females. We conducted a retrospective, interventional study on 156 eyes (78 patients) that had been diagnosed with dermatochalasis and had undergone upper lid blepharoplasty at the Korea University Hospital between August 2008 and October 2008 by a single surgeon. Twenty-eight male patients and 50 female patients were enrolled. Patient age, sex, follow-up duration, complications, and treatment were analyzed. We evaluated intraoperative (1) lid crease height, (2) skin-muscle excision amount, and (3) whether or not fat was removed. In total, 78 patients (28 men and 50 women: 156 procedures) who underwent upper eyelid blepharoplasty for dermatochalasis were identified. The mean age was 59.6 years in male patients, and 62 years in female patients (P = 0.165). No significant difference was observed between mean lid crease height and the distance between eyebrow lower margin to lid crease in males and females. The amount of skin-muscle excision in the female group was significantly greater than that in males. The frequency of fat removal was significantly lower in males than in females. For a good cosmetic outcome, we recommend (1) lower lid crease, (2) less skin-muscle excision using a scalpel shape design, (3) lateral orbicularis oculi muscle preservation, and (4) minimizing fat removal to avoid feminization in older male upper blepharoplasty.