The appearance and aggravation of under-eye bags is one of the signs of facial aging and gives the impression of unspirituality. Therefore, the formation of bags under the eyes is caused by pathological changes in the tissue structure, and this condition can only be treated by plastic and cosmetic surgery. Lu Jiu-ning, Plastic Surgery Department, Minhang District Hospital of Traditional Chinese Medicine, Shanghai, China Bags under the eyes are puffiness of the lower eyelids. Because the skin of the eyelids is very thin and the subcutaneous tissue is thin and flaccid, edema can easily occur, thus producing bags under the eyes. There are many factors that contribute to the formation of under-eye bags, genetics is an important factor, and it becomes more and more obvious as we age. Along with under-eye bags, many people have more prominent dark circles under their eyes. Dark circles under the eyes are mainly due to the prominence of fat under the eyes, blood vessels gathered at the epidermis of the eyes, and slower venous blood circulation. After fat extraction, dark circles under the eyes can be improved significantly, and the incision at the root of the eyelashes will not leave scars. The earlier you do the surgery to remove eye bags, the better the result. When you are young with good skin elasticity, the recovery of removing eye bags is fast, as long as the incision is made from inside the eye and the fat is directly removed, there is no need to remove the skin, and there is no trace outside at all. As we grow older, more and more fat accumulates near the lower eyelid, the skin pressure follows, and over time, the skin is loose, then you can only remove part of the skin while taking out the fat, so that you can effectively remove the bags under the eyes. Types: 1.Congenital type (simple orbicularis oculi hypertrophy), only need to thin the orbicularis oculi muscle, no need to remove fat. 2.Fine lines type (simple skin laxity), only need to remove excess skin, no need to destroy other tissues. 3. For the fatty type (simple lower lid with mild to moderate bulging), only the excess orbital fat needs to be removed through the internal method. 4, Skin loosening type (skin loosening with fat bulge), lid margin incision, removal of skin and box fat, and frame repair. 5, Aging type angle (loose skin, fat prolapse, deep wrinkles), to remove the skin, fat backfill, and eye lift. Methods: 1, bilateral internal incision: suitable for tight skin, only fat expansion, light age group 2, bilateral external incision: suitable for older people with severe skin laxity 3, comprehensive rehabilitation: incision: a small incision at the root of the eyelashes, extract the fat from the orbital septum, fill and fix it on the already separated infraorbital periosteum, make the depression flat, repair and strengthen the orbital fascia, suspend the loose orbicularis oculi muscle to the orbital periosteum. This will not loosen it, and then remove the excess skin. Results: 1. eyelid flattening 2. wrinkle reduction 3. skin tightening 4. muscle collection and depression filling 5. small amount of surgical traces in skin incision 6. a few initial redness of incision and mild scar growth, generally 1-3 months to fully recover. 7, not easy to recur: the first time the skin of eye bags, orbicularis oculi and fat removal behind the orbital diaphragm is not easy to recur, usually it is not easy to recur. Because the human body is mainly adipose tissue in adulthood, and fat cells are not increased. What is the reason for the failure of eyebag removal surgery? 1, lower lid ectropion: lid ectropion is divided into three degrees Treatment: one degree can be treated with local massage or local injection to promote the lower lid skin relaxation, generally a few months to recover or improve. In second and third degree cases, the lateral V-shaped skin can be excised and sutured, or the orbicularis oculi muscle flap can be fixed on the canthus orbitalis periosteum, or the upper lid rotation flap, nasal flap, or temporal flap can be used to correct the ectropion, or in severe cases, a free skin graft can be performed. 2. Tear dots ectropion Treatment: Mild ectropion is treated with antibacterial eye drops to prevent conjunctival inflammation and massage of the inner canthus of the eyelid after the swelling has subsided. 3, lower eyelid skin depression Treatment: If the fat removal is excessive or the sutures in the orbital septum are too tight, another surgery must be performed to separate the skin depression and its surrounding area along the original incision, and repair the depression with the surrounding orbicularis muscle and subcutaneous tissue. 4.Poor wrinkle removal Treatment: Re-surgery to remove excess skin. 5.Cut scar, edema Treatment: Improve by physical therapy, hot compress, drug injection and other methods. The specific treatment method needs to be decided according to the actual situation of each person after examination.