The formation of under-eye bags is mainly related to the aging of facial tissues and degenerative changes, which may be caused by either lower eyelid skin laxity or lower eyelid muscle or fascia laxity, resulting in herniation of orbital fat. However, the formation of bags under the eyes is not always caused by aging, such as excessive eye use, and most office women are more or less associated with this. In addition, simple hypertrophy of the orbicularis oris muscle, mostly seen in young people, also known as “sleeper silkworms”, should not be categorized as eye bags, and the procedure should be determined according to the patient’s lower lid condition, such as the degree of skin and orbicularis muscle laxity, the number of wrinkles, orbital fat increase or herniation, etc. This will ensure results and remove bags and lower lid wrinkles, etc. Types of eye bag surgery In terms of the choice of incision, there are two types of eye bag surgery: the internal approach and the external approach. Internal approach: It is suitable for young people who simply have too much orbital fat displacement or bulging without skin laxity. Because it cannot lift the lower lid orbital septum and remove the excess sagging skin. The incision is made about 1mm from the lower eyelash margin, and a linear incision is made in the outer skin of the lower lid to open the orbital septum layer by layer, remove the fat, and remove the orbicularis muscle and lower lid skin as appropriate. If there is a tear trough or orbito-zygomatic groove, fat release, graft filling- and tightening or refixing of the orbital septum fascia will be required. Related Questions and Answers I. Will there be after-effects after eye bag surgery? The most common undesirable problem after having eyebag removal surgery is the excessive amount of lower lid tissue removal, thus causing lower lid ectropion, which will usually recover gradually. Second, will there be scarring at the incision after surgery? The incision line of eyebag surgery is very fine, and there may be a red mark within 2 weeks after surgery. Generally, after a period of time, the incision line will return to normal and no scar will be left, and even if a scar is formed, it is usually not easy to notice. Third, after the removal of eye bags, will it rebound? Generally, it is not easy to rebound within three or four years after surgery. In addition, whether it will rebound or not is also related to the specific operation, for example, whether to do folding and tightening suture on the orbital septum for orbital fat herniation type eye bags is very critical, of course, what kind of technique to be used depends on the specific situation.