Blepharoplasty surgery is a common clinical surgery for eye rejuvenation. At present, there are two main surgical methods for blepharoplasty surgery, which are internal resection method and external resection method. The internal resection method is through the conjunctival approach, and the external resection method is through the skin approach. The external resection method may damage the structure of the orbicularis oculi muscle of the lower eyelid margin, resulting in the disappearance of the lower eyelid eye and the loss of the original dynamic beauty of the eye. Therefore, the protection and reconstruction of the pretarsal bulge is of special importance in blepharoplasty surgery. This article will systematically review the methods of the protection and reconstruction of the pretarsal bulge in blepharoplasty surgery, and summarize their respective advantages and disadvantages, in order to provide some reference for clinical practice.