External eyelid bag removal is one of the most common cosmetic surgical procedures performed in clinical practice today, but there are risks associated with any surgical procedure. Eyelid ectropion, hematoma and infection may occur after surgery if adequate preoperative evaluation is not done. Therefore, the operator needs to make a correct prediction of the patient’s skin laxity, muscle laxity and fat laxity before the surgery, and to have a good communication and exchange of information. The risks of external incision eye bag removal surgery are as follows: 1. Eyelid exophthalmos: this symptom is the most common, mostly caused by the underestimation of the amount of skin tissue removed during the surgery, resulting in excessive resection; 2. Impact on vision: Incomplete stopping of bleeding after the surgery may result in intra-orbital septum hemorrhage, and the hemorrhage will compress the eyeballs, affecting the vision; 3. Undesirable appearance and shape: if too much fat is removed, this may result in sunken eyes. Removal of too much orbicularis oculi muscle or muscle may cause lower lid ectropion, lower lid recession and other undesirable appearance; 4. Adverse reactions: excessive removal may cause lower lid ectropion, and there may be adverse reactions such as easy tearing, incomplete eye closure, and frequent eye congestion and inflammation.