This set of lower lid blepharoplasty before and after photos features a 44 year old nurse practitioner female who over the last 10 years has developed significant puffiness to the lower eyelid area. Particularly in the nasal and central compartments. She denied any allergies but is under a lot of stress caring for two aging parents for many years. Examination confirmed the herniated fat pads. In order to correct this she underwent a lower lid blepharoplasty utilizing a subciliary incision with a skin muscle flap. Care was taken to remove just enough fat to coincide with the inferior orbital rim so as not to result in a tear trough deformity. Her post op course was unremarkable. Six weeks later she is well healed and has a very bright appearance to her eyes. She no longer has that tired sad appearance. She has even had the pleasure of being asked for age verification on several occasions when out with her husband.