Puffy, saggy lower eyelids make the eyes look tired no matter how well rested the body is. Aging causes the fat pad of the cheekbone to drop, creating a hollow under the eye. Fat pads around the eye can bulge forward, creating a "double bubble" or two separate convexities from the lower eyelid to the cheek. Repositioning of the cheek fat pad, sculpting the "tear trough" or natural hollow from the corner of the eye, removing excess fat and skin and tightening the skin through peels all help to rejuvenate this area and make the face look less tired. The procedure is done through an incision either directly under the eyelashes or through the inside of the lid (so there are no visible scars) and can be performed under sedation. Healing takes 1-2 weeks on average. Unlike the upper eyelid, lower eyelid surgery is almost never covered by insurance as it is deemed cosmetic in nature.