The appearance of bags on the lower eyelids is a common deformity of the lower lids that gives a tired and aged appearance. It can appear at any age. There are many reasons for the formation of under-eye bags, commonly bulging with increased fat, but also due to skin laxity, orbicularis oculi hypertrophy, lid laxity, or orbital bone protrusion. These deformities can exist alone or several at the same time. In general, eyelid skin and muscle laxity, orbital fat bulge, and lid laxity are often due to age, but orbicularis muscle hypertrophy and orbital fat bulge can be congenital. The age of surgery for congenital factors is generally early, around 20 years old, while age-related laxity deformities are often operated on after 25-30 years old. Eye bag deformity is manifested by the appearance of transverse fine wrinkles in the local skin or the appearance of reticular wrinkles, radial wrinkles in the lateral skin of the lower lid when smiling, or even the formation of a skin bag, a transverse band in front of the lid plate in cases of orbicularis oculi hypertrophy, which is more obvious when smiling; the skin of the lower lid bulges outward; in severe cases, the lower lid drops down and even separates from the eyeball, which is what we call sclera (white eyeball) exposure or “lid-ball separation”, mostly seen in the elderly. The surgical method chosen to correct the bags under the eyes can depend on the local condition. If only the fat is bulging and the skin is not lax, orbital fat removal can be performed via the conjunctival sac. This method has less surgical damage, no skin incision, quick recovery and is easily accepted by patients, and is suitable for young patients with good skin elasticity. If the skin is lax and the fat is bulging, skin incision should be used. There are two types of surgical approaches, one is subcutaneous and the other is under the orbicularis oculi muscle. Since the fat tissue between the skin and the orbicularis oculi is very thin, it often damages the orbicularis oculi during separation, bleeds more, and is easy to form a hematoma after surgery, so it is generally used sparingly. The suborbital pathway is a normal anatomical level with few blood vessels, little surgical bleeding, and quick postoperative recovery, and is used more often in clinical surgery. Through this pathway, ancillary procedures such as partial removal of orbital fat, tightening of the orbital septum, partial removal of the orbicularis oris muscle (hypertrophy or laxity of the orbicularis oris), tightening of the orbicularis oris (laxity of the orbicularis oris), or partial removal of the lid (separation of the lid in old age) can be performed, depending on the situation.