The transconjunctival technique for lower lid blepharoplasty, by virtue of a reduced rate of lower eyelid malposition, improved healing, and a concealed incision, has some appeal compared with the transcutaneous method. The transconjunctival approach to lower lid blepharoplasty provides access for both fat resection and transposition to soften tear trough deformities and correct infraorbital fat herniation. Transposing a contiguous orbital septum/fat unit is key for fat replacement and repositioning. Overall, there is a paradigm shift that has focused more on enhancing lower lid-cheek shape and contour and preserving orbital volume.