59-year-old female presented with her husband to discuss a number of cosmetic concerns. She notes she lost a significant amount of weight several years ago and since that time, she has made overall health a priority. She has seen a great deal of success but notes some residual issues that seem to be exacerbated with aging. She has some concerns about facial aging as well. She was concerned about the “baggy” appearance of the lower lids that she said developed later in life. To address this, she had a bilateral lower lid blepharoplasty with minimal skin resection, minimal superficial fat resection, and fat grafting at the infraorbital rim and malar area. The procedure was performed in-office in our fully accredited (AAAASF) facility under local anesthesia. Results shown at 5 weeks.