Post op six months from upper and lower bleph, fat repositioning, skin pinch and muscle tightening. I still have noticeable tear troughs/. I look almost identical to my pre op pics when compared. I still look tired and am embarrassed as there are little fat bulges where he repositioned the fat on my lower lids. He also stated that we only have so much fat to work with under the eye and that is all he had to work with. Now he is suggesting fillers in order to make the tear trough look better.