This is a 43 year-old female who presented with aging of her lower eyelids. On exam she had loss of cheek volume, dark circles around her eyes (tear trough deformity) and significant skin excess of her lower eyelids. We did bilateral lower eyelid blepharoplasties with removal of skin via a subciliary incision and fat grafting to the upper cheeks and tear trough area. We used special fat processing techniques with microfat to the cheeks to help with loss of cheek volume and nanofat to the tear trough deformity to improve the dark circles and skin texture. She had the procedure at our JCAHO accredited facility in Downers Grove, IL. The patient had an uneventful postoperative course and at three months had a noticeable improvement in skin texture of the lower eyelids, improved upper cheek volume, and an improvement in the dark circles.
