It is the wish of many beauty lovers to have a pair of beautiful and bright eyes. However, whenever you face the mirror, have you ever been worried about your “bulging eyes”? I believe that many people have experienced this. In the cosmetic surgery clinic, many patients do visit the clinic to remove their “bulging eyes”. Many of these patients are relieved by simple blepharoplasty, commonly known as “double eyelid surgery”. However, some of these patients have bloated upper lids due to “tear duct prolapse”. In these cases, blepharoplasty alone will not alleviate the “bulging eyes”, and it is difficult to achieve a “beautiful” eyelid shape. Therefore, patients who wish to treat “bulging eyes” and those who wish to have double eyelids should first determine if they have a prolapsed tear duct. Lacrimal gland prolapse is a congenital or acquired cause of lacrimal gland septum relaxation, resulting in forward prolapse of the lacrimal gland. In patients with lacrimal gland prolapse, the upper lid is full on the outside, the upper lid skin is soft and loose, and in some patients the upper lid may cover the outer upper cornea. The lacrimal gland is repositioned in the lacrimal fossa by pushing on it, and the bloated upper lid improves, but then protrudes again as before. Therefore, if you have a predominantly lateral upper lid bloat, it is important to consider the possibility of a prolapsed lacrimal gland (see Figure 1 for a diagram). Figure 1: Diagram of the appearance of a prolapsed lacrimal gland If a diagnosis of prolapsed lacrimal gland is confirmed, a corrective lacrimal gland surgery will be required. The “bulging eyes” can be corrected by re-fixing the bulging light pink lobulated lacrimal gland tissue in the lacrimal fossa. This procedure can usually be performed in conjunction with blepharoplasty (see Figure 2 for a schematic postoperative result). The post-operative care for lacrimal gland prolapse is also relatively simple and is essentially the same as for simple blepharoplasty. Generally, you only need to apply ice for 24 hours after surgery, practice opening your eyes after 24 hours, and avoid late nights and eye strain. The medication is changed 1 day after surgery and the stitches are removed 7 days after surgery. The incision should not be exposed to water before the stitches are removed. Therefore, the procedure basically does not affect the patient’s life and work.