This gentleman wanted to change the appearance of his eyelids but didn't want to look too different. For the upper lids, we removed skin and muscle as well as a little fat. The lower eyelids were more complicated. We transposed central fat to fill the tear trough deformity and debulked the middle and lateral fat pads. We tightened his obicularis muscle with an obicularis pexy. His recovery was uneventful and he is pleased with his result.