Xanthelasma are yellow patches seen on the inner two-thirds of the upper and lower eyelids. One- third of these individuals have high serum cholesterol. In some patients, the xanthelasma are so extensive that they cover most of the eyelids and yield an unsightly appearance difficult to conceal with makeup. Laser resurfacing and chemical peels simply do not work. A highly skilled oculofacial surgeon can perform complete excision of these plaques followed by reconstruction of the defect .