Purpose: Blepharoplasty in the office under local anesthesia and oral medication is popular for several reasons. The present study reviews the authors' experience with this approach, evaluating patient satisfaction, and demonstrating why this technique has become their procedure of choice in selected healthy patients. Methods: The authors conducted a retrospective review of the 86 patients who underwent office-based blepharoplasty and mailed surveys to assess patient satisfaction with the procedure. Results: Upper and lower blepharoplasty were performed with no major complications. Eighty-three percent of patients completed and returned surveys. Survey results indicated this procedure to be well-accepted and highly rated by patients. Many patients unwilling to undergo blepharoplasty outside of the office were willing to have the procedure using this approach. A strong majority indicated they would be referring friends and family for the procedure. Conclusions: The fact that blepharoplasty can be performed in the office under local anesthesia with oral medication proves to be a strong determinant toward the final decision to undergo surgery. This procedure meets the safety requirements outlined by the ASPS and is desired by our patients for its many obvious advantages. Recommendations are provided to assist others who desire to utilize this safe and cost-effective method.