For young and middle-aged patients (less than 35 years of age) who only have bulging lower eyelid fat tissue and good skin elasticity, or for older patients who are more concerned about skin incision scarring but do not have loose lower eyelid skin, the so-called internal incision surgery can be chosen as an alternative to the lower eyelid conjunctival approach for under-eye bag revision. This procedure does not remove the orbicularis oculi muscle or lower eyelid skin, is less invasive, does not require postoperative sutures, and does not result in lower eyelid recession, ectropion, or scarring of the incision, resulting in a quicker postoperative recovery. For patients with loose skin on the lower eyelids, the so-called external incision surgery, which is the most commonly used procedure, can be performed through a transcutaneous approach. This procedure involves an incision at the base of the lower eyelashes, a wedge-shaped excision of a piece of orbicularis muscle and skin near the outer corner of the eye, and then restoring the elasticity and tone of the orbicularis muscle through magical plastic surgery techniques. The advantage of this procedure is that it lifts the sagging lower lid skin and mid-face skin upwards, giving the face a more youthful appearance. However, it is relatively more invasive and takes longer to recover from postoperative edema and bruising. A linear surgical incision scar will remain after the procedure, but since it is at the base of the lower eyelashes, it is not very noticeable.