This 24-year-old woman presented with asymmetric, multiple creases and desired double eyelid surgery, and mild lower eyelid fat prolapse which made her look tired. Her goal was for naturally low Asian crease, but with an “in/out Fold” medial crease configuration which is a compromise between “in fold” (tapered) crease, and an “out fold” (parallel) crease. She also wanted a medial epicanthoplasty to open up her eyes horizontally. Dr. Amadi performed infold/outfold double eyelid surgery with medial epicanthoplasty and lower eyelid blepharoplasty with fat transposition. The patient was absolutely delighted with her results which she stated exceeded her expectations, and she is only 2 months out from surgery which means her scars will continue to improve!