A technique that addresses lower eyelid aging changes such as prominent fat pockets and excess skin. The approach uses a direct incision below the lower eyelid eyelashes (transcutaneous approach) to remove the prominent fat pockets and skin. Redundant orbicularis muscle can also be addressed by an orbicularis suspension. The incision made usually heals very well with little signs of scarring. Canthoplasty or canthopexy may have to performed at the same time.