According to Dr. Francis Palmer, a Beverly Hills plastic surgeon, the transcutaneous lower eyelid blepharoplasty technique is an older technique that plastic surgeons sometimes use. In this technique, the incision is placed in the skin of the lower eyelids just below the eyelash margin. With this technique, the incision must go through the lower eyelid muscle and then into the orbital septum in order to have access to the fatty tissue that needs to be removed. After the fat has been removed, the excess skin and muscle is trimmed down and the incision is closed. Complications from these procedure may arise due to cutting the muscles.