Some patients come in requesting lower eyelid rejuvenation and ask what types of techniques do I use. I really use a number of different techniques depending upon the specific anatomy of the patient who want to be treated. There are times I do what is called as pinch blepharoplasty where it looks like it have some an extra skin and I’ll take a little bit of extra skin off the lower lid lash line. If they have bulging fat often what I’ll do is I’ll do it through the inside what’s called a trans contact divulge section of fat by making incisions on inside between the globe and the outer skin as you won’t see incisions to get the fat out. I tried not to violate the muscle in those excises and then if I need to take out skin in the outside I will. There are occasions that I will re-drape the fat on the lower lid margin, cheek margin and also the soft tissue over there to break up the contours sometimes xxxx the area as well. If patients have laxity over the lower lid I’ll sometimes do what is called the xxxx and secure the lateral lid margin up along the inner border of the bony orbit to prevent the eye from falling down. This to me is like a belt in suspender kind of approach to help minimize the explosion of the lower lid but it really depends upon the different individuals anatomy that will tell me what techniques that I use for the lower lid.