This patient presented with classic hypothyroid festoons, ie: the large bags under her eyes. She had several other strong signs of hypothyroidism at the time of examination, including the swelling of the legs and ankles, the facial swelling, the thinning hair, fatigue, and leg cramps. Subsequent medical work-up confirmed the diagnosis of primary hypothyroidism. The true, underlying cause was still unknown at the time of this writing. The patient was treated with Synthroid (levothyroxine) and improvement was rapid. The festoons reduced greatly in size, but the excess skin remained, and was removed by a local oculoplastic surgeon.