What is the difference between aggressive post-septal fat excision, conservative excision, or post-septal fat repositioning?

Excessive removal of post-septal or peri-orbital fat that causes lower lid bulging is thought to cause a hollowed out appearance to the eyes in the long-term post-operative period. No good studies to this effect have been carried out, but the thought and the anecdotal evidence does seem to indicate that post-septal fat excision should be conservative, or just enough to get the job done. Aside from removing the fat, a good approach has been to position a tongue of the fat within the lower lid groove, especially towards the nasal side to fill in the circles under the eyes, and smooth the transition between the cheek and lower lid fat.