As mentioned before, there are various manifestations of under-eye bags, and each person shows one or the other characteristics. According to my experience, the bags under the eyes are simply divided into four types: simple orbital fat herniation type, simple skin orbicularis muscle relaxation type, orbicularis muscle hypertrophy type and mixed type. 1, simple skin orbicularis orbitalis type: This type is characterized by lower lid skin laxity with varying degrees of fine wrinkles, orbicularis orbicularis muscle sagging, with obvious folds or arched infraorbital border. The herniation of orbital fat is not obvious, but the orbital rim is clearly outlined, with a lack of soft tissue and a hollow pre-zygomatic area, commonly seen in middle-aged and older people who are thin. This type is suitable for external orbital septal reinforcement, orbicularis oris muscle lifting and suspension, dermatologic removal, and if necessary, autologous fat filling of the tear trough and apple muscle to restore a youthful and full appearance. 2. Simple orbital fat herniation type: This type has no obvious laxity of the skin and orbicularis muscle, and no obvious wrinkles around the orbit, but the lower lid bulge is obvious. This type is mainly seen in younger people with a family history of heredity. Often the client will report that the bulging is more pronounced when he/she is tired, sleep deprived, or when women are menstruating. This type is the best indication for internal incision eye bags. If the guest’s tear trough is not obvious, it is the lower lid that bulges too much, you can do an internal incision simple liposuction. This method is very effective, that is, you can remove the bulging fat and solve the tear trough, killing two birds with one stone. 3.Simple orbicularis oculi hypertrophy type: This type is also not uncommon, refers to the smile in the place near the edge of the lid appears a bulge, some scholars will be called muscle eye bags. In fact, it is due to the hypertrophy of the orbicularis oculi muscle, which contracts when smiling expression. You may notice that its position is actually equivalent to the position of the eye plateau (sleeper silkworm). Nowadays, it is very popular to use hyaluronic acid to create an eye plateau, but if this eye plateau is too thick and not delicate, it will not look good either. For this type, you can inject two points with botulinum toxin in the most fatty place, and 1-2 units per point can be easily solved. 4.Mixed eye bags This type is the most common, manifested as loose skin, orbicularis muscle hypertrophy, orbital septum relaxation fat herniation. With the performance of the first three types. Usually seen in middle-aged and older people over 40 years old. This type is suitable for external incision, orbital septal fat release or excision, choroidal suspension and tightening, and dermaplaning. However, some mild to moderate clients can also consider internal incision to remove fat or fat release and then use skin pinch to simply remove the excess skin, which also has good results, this method is most used by plastic surgeons in Europe and America.