Eye bags, which occur mainly in the lower lid, appear as a pouch-like overhang of bloated tissue in the lower lid. There are three fat globules in the lower lid below the orbital septum: inner, middle and outer. In middle-aged and older people, especially those who do not sleep well, the fat globules push out the orbital septum due to sagging and form a pseudo-orbital fat hernia above the inferior orbital rim, which is known as an under-eye bag, accompanied by varying degrees of skin laxity. The appearance of bags under the eyes seriously affects the appearance, giving people a fatigue and old appearance and the impression of mental discomfort, and thus eye bag surgery is increasingly becoming one of the common procedures in cosmetic clinics. There are two types of incisions for under-eye bag surgery: skin approach and conjunctival approach. The skin approach is what we usually call “external” eye bag revision, while the conjunctival approach is also known as “internal” eye bag revision. 1, skin approach (external cut method) This is the most commonly used method of eye bag revision, through the skin approach, not only can remove the herniated orbital fat ball, but also remove the excess skin, effectively reduce the lower lid skin wrinkles and outer corners of the crow’s feet, to achieve the double effect of “peel and remove fat”. In patients over 30 years of age, the skin is generally sagging to varying degrees, and after removal of the septal fat globules, the sagging will become more pronounced, so the septal fat globules are usually removed by external excision and the excess skin is removed to achieve good lower lid rejuvenation. The amount of skin removed is very much an art, too much cutting can cause lower lid ectropion, too little wrinkle removal is not effective. This is a problem that is not difficult for professional plastic surgeons to handle. The external cut is very concealed and is generally designed parallel to the lid margin, along the outer row of lashes 1mm below the lid margin, and laterally in the direction of the crow’s feet at the corner of the eye. The skin incision is usually closed with 7-0 cosmetic sutures and the sutures are removed in 4 days. The incision is not obvious and the swelling time is short (usually about 10 days for basic recovery). 2.Conjunctival approach (internal incision) The conjunctival approach (internal incision) is mainly suitable for young people with primary eye bags without lower lid skin and muscle laxity. The advantage of this method is that it does not require separation of the orbicularis oculi muscle, tissue damage is small, the incision is on the conjunctival surface of the eyelid, generally without sutures, and the skin has no exposed incision marks. The internal incision method requires more skill due to less exposure of the operative area and is usually done by an experienced professional plastic surgeon. The internal approach is not advisable for those who are a little older because it does not effectively address the problem of lower lid skin laxity, and the laxity of the skin can even become more pronounced after surgery. In this case, the external incision method is usually to be used. Eye bag surgery, with less trauma, faster recovery (usually about 10 days to fully recover) and obvious results, has become the second most common facial cosmetic surgery after double eyelid surgery.