56 year old female, complained of looking tired and older. She underwent transconjunctival lower blepharoplasty with fat/bags repositioning (to fill hollow tear trough area, dark circles) and skin pinch removal. Note more rested eye appearance without change in eye shape with natural results. She also had concurrent skin only upper blepharoplasty. Before and 6 weeks after cosmetic quad-blepharoplasty photos are shown. (In future, she would benefit from upper eyelid filler injection to improve pre-existing hollow, sunken upper eye area.)