Wrinkles or light skin excess of the lower eyelids can often be treated without surgery by laser therapy.
If the skin excess is mainly in the lower part of the eyelid it can sometimes be treated by direct excision, because scar formation in this area is usally very inconspicuous.
Removal of skin from the lower eyelid by incision under the eyelashes can easily provoke a permanent "operated look", leaving a bit of the white part of the eye (the sclera) exposed under the iris, and displacing the lowest point of the lid border laterally and inferiorly. Therefore it is only performed in case of large skin excess.
Removal of excess fat from the lower lids may be appropriate in young people who naturally have baggy lids. However, most baggy lids are the result of ageing, and better treatment alternatives exist. The displaced fat belongs in the orbit and can be repositioned or used to hide a bony orbital margin, rather than removed.
Sometimes, operations on the fat tissue of the lower eyelid can be performed through the inner eyelid lining, avoiding external scars.
Lower lid rejuvenation can be combined with mid-face lifting to reposition the soft tissues over the cheekbone.