The indication for lower lid blepharoplasty is the desire to improve the appearance of the lower lids and/or midface. Patients who have herniated post-septal fat-pads (the fat pockets surrounding the eye), lower lid rhytids (wrinkles), and excess skin (though less typical) would benefit from excision of the herniated fat, and a conservative skin excision with lower lid tightening. The presence of droopy malar fat pads (the fat pads of the cheeks), hollows in the medial periorbita (to the lower inside of the eye), and smile lines, would benefit from added inferior dissection and lifting of the midface (a midface lift).