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Background. Patients with prominent periorbital fat pads often complain of having a persistent “tired” look and seek treatment from their dermatologist.

Objective. A non-surgical treatment of fat pads.

Methods. Thirty patients were treated for prominent lower eyelid fat pads with phosphatidylcholine injection. Pre- and posttreatment photographs were taken for long-term analysis.

Results. A marked reduction of the lower eyelid fat pads was noted over the 2-year follow-up period. There were no recurrences.

Conclusion. The injection of phosphatidylcholine (250 mg/5 ml) into the fat pads is a simple office procedure that may postpone or even substitute for lower eyelid blepharoplasty.