This patient was bothered by her heavy and crowded upper lids and felt that they were beginning to make her appear tired. Her exam was uniquely notable for heaviness along her lateral upper lids, more so on the left than right. This was consistent with lacrimal (tear) gland ptosis (droop). She is now recovered from an upper blepharoplasty and lacrimal gland repositioning. The combination of procedures produce a more alert and youthful gaze. Both patient and doctor could not be more thrilled with her results.