Best suited for patients with excess skin in addition to under-eye fat. In cases where a patient has both excess fat and sagging skin, an external incision approach can be used to remove the fat while simultaneously addressing the skin. The incision technique used here is a proprietary Teeraporn specialized method for scar placement. 

This technique also aims to leave no visible scarring once the incision has healed. Beyond removing fat and trimming excess skin, this method can also be used to tighten the lower eyelid tendons, which helps to smooth the skin and elevate the tear trough area.