A 23 year-old woman complained of sunken upper eyelids and absence of skin creases (double eyelids) which made her looked tired and older. She had consulted another doctor who recommended filler or fat injection. However, she was concerned that the injection may not last and the associated period of post-injection swellings. I performed bilateral double eyelid surgery with simultaneous posterior conjunctivomullerectomy to widen the eyes and pulled forward the fat to fill the sunken areas. The picture below was taken 2-month postoperative.