49 year old female, who had history of 3 previous cycles of under eye hyaluronic acid gel (Juvederm and Restylane) injections to fill “hollow” under eye area (tear trough), followed by hyaluronidaze injection to get rid of “excess filler”, resulting in puffy, unnatural under eyes area. After examination, it was determined she had more under eye fat prolapse with some residual filler. She underwent transconjunctival lower blepharoplasty (scar-less, stitch-less incision inside the lower eyelid) with fat repositioning. This revision cosmetic eyelid procedure was done under local anesthesia in our Beverly Hills office. Note the improved, smoother under eye (lower eyelid) appearance after surgery. Preop and 3 months postoperative photographs are shown.