Under-Eye Fat Repositioning

Under-Eye Fat Repositioning

Understanding Your Under-Eye Concerns and Surgical Options

Under-eye bags, hollowness, and sagging skin can make the eyes appear tired or older than you feel.

Although these concerns may look similar, their underlying causes can be different. Some are related to protruding orbital fat or tear trough hollows, while others involve loose skin and changes in the surrounding tissues.

The right surgical approach depends on what is causing your under-eye concerns.

At IBON Plastic Surgery, Dr. Kim carefully evaluates your individual anatomy to determine whether transconjunctival fat repositioning or lower blepharoplasty may be more appropriate for you.

The goal is to create a smoother, more balanced under-eye contour while maintaining a natural appearance.

01. Understanding Under-Eye Concerns

Why Does the Under-Eye Area Change?

The appearance of the under-eye area is influenced by orbital fat, skin elasticity, underlying facial structure, and the condition of the surrounding soft tissues.

Changes in these structures can create different concerns, sometimes occurring together.

Under-Eye Bags

Bulging beneath the eyes

When orbital fat protrudes forward, it can create noticeable bags beneath the eyes.

The contrast between the protruding fat and the surrounding areas may make the under-eye contour appear uneven.

Tear Trough Hollows

A noticeable groove beneath the eyes

Hollowing between the lower eyelid and cheek can create a distinct groove or shadow.

This may occur with or without prominent under-eye bags.

Sagging Skin and Wrinkles

Loose skin and changes in the surrounding tissues

As skin elasticity decreases and the surrounding tissues change, excess skin and wrinkles may become more noticeable.

When significant skin or muscle laxity is present, fat repositioning alone may not adequately address these concerns.

Shadow-Related Dark Circles

Darkness caused by uneven contours

Under-eye bags and tear trough hollows can create shadows that make the area appear darker.

Surgery may help improve these structural shadows, but dark circles caused primarily by pigmentation or visible blood vessels may require a different approach.

02. Two Approaches to Under-Eye Surgery

Different Concerns Require Different Surgical Approaches

Under-eye surgery is not a one-size-fits-all procedure.

The choice between transconjunctival fat repositioning and lower blepharoplasty depends on the condition of the orbital fat, skin, and surrounding tissues.

Both procedures aim to improve the under-eye contour, but they address different anatomical concerns.

Transconjunctival Fat Repositioning

For Under-Eye Bags and Hollowness Without Significant Skin Sagging

Transconjunctival fat repositioning is performed through an incision inside the lower eyelid.

The orbital fat is repositioned to improve under-eye bulging and hollowness, creating a smoother transition between the lower eyelid and cheek.

Because the procedure does not require an external skin incision, it does not leave an external skin-incision scar.

This approach is generally considered when the skin and underlying muscle have relatively good tone and do not require tissue removal.

• Key Features

· Addresses under-eye fat bulging and tear trough hollowness.

· Uses an incision inside the lower eyelid.

· Does not require an external skin incision.

· Does not remove excess lower eyelid skin.

· May be combined with SOOF lifting or fat grafting when needed.

Lower Blepharoplasty

For Under-Eye Bags Accompanied by Sagging Skin

Lower blepharoplasty using a transcutaneous approach is performed through an incision in the lower eyelid skin.

This approach allows the surgeon to address excess skin and, when indicated, the underlying muscle and orbital fat.

It may be considered when under-eye bags are accompanied by significant skin laxity, wrinkles, or sagging of the surrounding tissues.

The surgical plan is tailored to the patient's anatomy and the degree of correction required.

Key Features

· Addresses excess lower eyelid skin and associated tissue laxity.

· Uses an external skin incision.

· Allows excess skin to be removed when needed.

· May address protruding orbital fat and tear trough hollowness.

· May include additional procedures depending on individual anatomy.

03. Which Approach May Be Right for You?

A Side-by-Side Comparison

The following comparison highlights the main differences between the two surgical approaches.

	Transconjunctival Fat Repositioning	Lower Blepharoplasty
Main Concerns	Under-eye bags and hollowness	Under-eye bags with significant skin or muscle laxity
Incision	Inside the lower eyelid	Through the lower eyelid skin
External Skin Incision	No	Yes
Excess Skin Removal	No	When needed
Fat Repositioning	Yes	May be performed when indicated
Suitable Candidates	Patients with relatively good skin and muscle tone	Patients who require correction of excess skin or tissue laxity

The presence of under-eye bags alone does not determine which procedure is appropriate.

Skin elasticity, muscle tone, fat distribution, and the degree of hollowness must also be considered.

In some patients, additional procedures may be recommended to address concerns that cannot be adequately improved by either approach alone.

The most suitable surgical plan is determined through an individual consultation.

04. A Personalized Approach to Under-Eye Surgery

Your Anatomy Guides the Surgical Plan

Every patient's under-eye anatomy is different.

Two people may have similar-looking under-eye bags but require different surgical approaches because of differences in skin elasticity, fat distribution, and the condition of the surrounding tissues.

At IBON Plastic Surgery, Dr. Kim carefully evaluates these factors before recommending a procedure.

The assessment focuses on identifying the underlying causes of your concerns and determining which surgical approach may provide an appropriate degree of correction.

When necessary, additional procedures such as SOOF lifting or fat grafting may be considered to improve the overall under-eye contour.

The goal is not to perform more procedures, but to select the approach that best addresses your individual anatomical concerns.

Personally Guided by Your Surgeon

Dr. Ju-Chan Kim, Medical Director
Board-Certified Plastic Surgeon in Korea

Dr. Kim personally conducts the consultation, develops the surgical plan, performs the procedure, and oversees postoperative follow-up.

This continuity of care allows your individual anatomy and surgical goals to be considered throughout the treatment process.

05. Before & After

Different Concerns. Individualized Results.

Explore actual surgical cases to see how different approaches may improve under-eye bags, hollowness, and sagging skin.

Each patient's anatomy and surgical needs are different, and the procedure is selected accordingly.

[Before & After Photo Gallery]

Individual results may vary. The procedures performed, including any additional procedures, are identified in each case.

06. Frequently Asked Questions

Q1. Is under-eye fat repositioning the same as lower blepharoplasty?

Not exactly.

Under-eye fat repositioning focuses on redistributing orbital fat to improve bulging and hollowness.

Lower blepharoplasty is a broader term that can include different surgical approaches. In this website, the Lower Blepharoplasty section focuses on the transcutaneous approach, which allows excess skin and associated tissue laxity to be addressed.

The appropriate procedure depends on your individual anatomy.

Q2. Can I have fat repositioning if I also have loose skin?

It depends on the degree of skin laxity.

If the skin and underlying muscle have relatively good tone, transconjunctival fat repositioning may be appropriate.

When significant excess skin or muscle laxity is present, a transcutaneous approach may be more suitable.

An individual assessment is necessary to determine the appropriate procedure.

Q3. Will there be a visible scar?

Transconjunctival fat repositioning is performed through an incision inside the lower eyelid and does not leave an external skin-incision scar.

Transcutaneous lower blepharoplasty requires an external skin incision, which may leave a visible scar.

The location and appearance of the scar depend on the surgical approach and individual healing.

Q4. Can under-eye surgery improve dark circles?

Under-eye surgery may improve dark circles caused by shadows from protruding fat or tear trough hollows.

However, dark circles caused primarily by pigmentation, visible blood vessels, or other factors may not improve with surgery alone.

Identifying the underlying cause is important when determining the appropriate treatment.

Q5. How do I know which procedure I need?

The most appropriate procedure depends on several factors, including the degree of fat protrusion, tear trough hollowing, skin elasticity, and surrounding tissue laxity.

During your consultation, Dr. Kim evaluates these factors and explains which surgical options may be appropriate for your individual condition.

07. Personalized Consultation

Find the Right Approach for Your Under-Eye Concerns

Under-eye bags, hollowness, and sagging skin do not always require the same surgical solution.

Choosing the right approach begins with understanding your individual anatomy and identifying the underlying causes of your concerns.

At IBON Plastic Surgery, Dr. Kim personally evaluates your under-eye area and discusses the surgical options that may be appropriate for you.

Whether you are considering transconjunctival fat repositioning or lower blepharoplasty, your surgical plan is developed around your anatomy, concerns, and aesthetic goals.

Explore Your Surgical Options

Transconjunctival Fat Repositioning

Learn more about improving under-eye bags and hollowness through an incision inside the lower eyelid.

[Explore Transconjunctival Fat Repositioning →]

Lower Blepharoplasty

Learn more about addressing under-eye bags accompanied by excess skin and tissue laxity.

[[Explore Lower Blepharoplasty →]](/services/lower-blepharoplasty-2)

For International Patients

If you are traveling from overseas, our team can assist with consultation scheduling and help you plan your visit.

Your final surgical plan will be determined following an individual medical assessment.

A personalized approach to a smoother, more balanced under-eye contour.

[Schedule a Consultation→]

Individual results and recovery experiences vary. Surgical suitability and the most appropriate treatment plan are determined through an individual medical consultation.