Below showed a case, before (left) and after (right), underwent fat excision lower bleparoplasty by skin incision.

Below case is younger. The operation procedure is fat excision through transconjunctival incision.

One of the benefit of fat transposition is that smile roll will be accentuated after surgery because fat is pulled down. Eyelid with smile roll looks younger that eyelid without smile roll. Below right is picture after surgery. Arrow pointed to smile roll.

Below show two cases of fat transposition lower blepharoplasty by external skin incision. 

 

　
Below show the before (left) and after (right) pictures of three cases underwent fat transposition lower blepharoplasty. For younger cases, transconjunctival incision would not leave scar. Recovery is quicker than skin incision.　

 Four-lid blepharoplasty: Below showed before (left) and after (right) pictures after four-lid blepharoplasty.