54 year old female who is “unhappy with her appearance when she looks in the mirror”. She is most unhappy with the “sagging eyes and bags underneath her eyes.” She also feels that her hairline is high, which leaves her with a “large forehead.” She feels like there is a decrease in volume throughout her face. Height is 5’2″. Weight is 200 pounds. Evaluation demonstrated that she had some brow ptosis (droop) that was contributing to her heavy upper lids; addressing only the excess skin of the upper lid without addressing the brow issue will not typically provide an optimal cosmetic appearance. Therefore, we proceeded with a brow lift (incision at her upper hairline). At the same time, she had a bilateral upper and 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 3 months.