Ms. Ding is a department manager, due to the needs of work, often have to work overnight. In the past two years, her colleagues said she was not as spiritual as before, and when she looked in the mirror, she really had bags under her eyes! When people reach middle age, their lower eyelids tend to swell, loosen and sag, called bags under the eyes. It is a symbol of aging in the human body. Mild to moderate bags can affect a person’s appearance and self-confidence, while heavy bags can give a feeling of old age because of the bloated lower lids that protrude outward. The lower eyelid is divided from outside to inside into the skin layer, the orbicularis muscle layer, the orbital septum, the intraorbital fat and the lid plate layer. Intraorbital fat consists of three groups of fat globules located below the orbital septum: medial, middle and lateral. The reason for this is that after middle age, the eyelid skin atrophies and relaxes due to water loss, the orbicularis oculi muscle sags, the orbital septum becomes less tense, and the intraorbital fat herniates out in front and below due to gravity, thus forming bags under the eyes. A small number of young people can also appear bags under the eyes, mostly due to family genetics, chronic diseases or irregular diet. After the formation of bags under the eyes, regardless of age, generally need to be treated surgically. According to the site of the surgical incision, there are two types of surgical methods, namely lower lid margin incision and lower lid conjunctival sac incision, and the steps are as follows: (1) Draw parallel lines at 2mm from the lower lid with US blue, cut the skin layer and orbicularis oculi muscle along the design line after local anesthesia, peel off the lower layer of the orbicularis oculi muscle to reveal and cut the orbital fascia, gently press the eye to remove the herniated fat, and suture the orbicularis oculi muscle and skin in layers. In recent years, many physicians believe that the formation of eye bags is mainly due to tissue relaxation of the anterior wall of the orbital septum rather than fat growth, so they do not advocate fat removal, but rather advocate that the herniated fat should be returned, so that the orbital septum and orbicularis muscle can be tightened and the excess part can be removed according to the degree of skin relaxation, and the skin can be closed with cosmetic sutures. This method is characterized by precise efficacy and easy operation, but the surgical damage is slightly large and the incision has a linear scar, which will gradually fade after 2-3 months of recovery. This method is especially suitable for patients with moderate or severe bags under the eyes. (2) Conjunctival sac incision, after local anesthesia, the conjunctiva and subconjunctival tissue are cut in the lid conjunctival sac, the orbital septum fat is separated, part of the orbital septum fat is removed and the incision is closed with continuous nylon sutures after thorough hemostasis. Its characteristic is that there is no skin incision, so it will not leave a scar, but this method has poor effect on medium to heavy bags, and is only suitable for young people and patients with mild bags. As with other surgeries, there are some complications after eye bag surgery. Common complications include lower eyelid ectropion, scar formation, hematoma, and collapse above the infraorbital rim. Avoiding these complications requires attention to a number of factors: first of all, it is best not to operate if the patient has a tendency to scar growth or keloid, and those who have a tendency to bleed should operate with caution. Surgical techniques are also important. The surgical operation should be gentle, the skin should be removed moderately, the hemostasis should be thorough, the amount of fat removal should be appropriate, and the sutures should be closed with cosmetic small fine needles. Patients should avoid smoking before surgery, stop taking contraceptives and anticoagulant drugs, and avoid surgery during menstruation, all of which are helpful to reduce the occurrence of surgical complications.