In her before and after photos she has had a lovely improvement. She had her lower eyelid fat bags removed using a plastic surgery approach from the inside of the eyelid. This approach is called the transconjunctival approach. She has no visible scar on her eyelid. The photos of her looking up are used to push lower lid fat outward and is used to determine if there is excessive fat. The after photo demonstrate that even with the eye looking up and pushing out the fat, there is no bag.
