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Under-Eye Fat Repositioning
Addressing dull under-eye circles and puffy lower lids at the same time. By smoothing the shadowed area beneath the eyes, the result is a brighter, more refreshed eye contour and a more youthful overall appearance.
Quick Facts
| Procedure | Under-Eye Fat Repositioning · Under Eye Fat Repositioning |
|---|---|
| Surgeon | Dr. Kim Seungsoo (Board-certified Plastic Surgeon, 10+ yrs) |
| Time | 30 minutes – 1 hour |
| Anesthesia | IV Sedation |
| Hospitalization | Not required |
| Stitch Removal | Not required |
| Follow-up Visits | 1 visit |
| Recovery | From 1 week post-op |
| Best For | Visible puffiness or protrusion of lower eyelid fat · Hollowing beneath the eyes contributing to prominent dark circles · Frequently told that you look tired or fatigued · Under-eye darkness that cannot be adequately concealed with makeup |
Check Point Highly Recommended For
Under-Eye Fat Repositioning Procedure
Precise Assessment
The degree of lower eyelid fat prolapse and the depth of the tear-trough depression are carefully evaluated.
Conjunctival Incision
A fine incision is made through the inner conjunctiva, leaving no visible external scarring whatsoever.
Fat Repositioning
The prolapsed fat is redistributed into the recessed tear-trough groove, filling and smoothing the transition.
Septal Reinforcement
The orbital septum is reinforced to prevent the repositioned fat from re-prolapsing, securing a durable result.
Under-Eye Dark Circles — Why They Form and How They Disappear
Under-eye dark circles are the combined result of a small amount of pigmentation that everyone has beneath the eyes, overlaid by a structural shadow. Under-eye fat repositioning does not directly remove pigmentation — instead, it changes the underlying structure that creates the shadow, making existing pigmentation nearly imperceptible.
| Cause | Everyone has a small amount of slightly deeper pigmentation beneath the eyes — almost invisible under normal circumstances. However, the orbicularis oculi muscle attaches firmly at the tear-trough groove, causing the fat above it to bulge. This creates a shadow beneath the bulge, which overlaps with the existing pigmentation and makes the under-eye area appear considerably darker. |
|---|---|
| Why is it so difficult to conceal with makeup? | Flat surface pigmentation alone can usually be covered effectively with concealer. However, when a three-dimensional shadow is layered on top, cosmetic cover-up has its limits — the darkness is especially pronounced under bright lighting conditions. |
| Surgical Principle | The tethering ligament is released and the prolapsed fat from above is spread and redistributed into the groove below. |
| The New Role of Repositioned Fat | The repositioned fat acts as a cushion, gently filling the transition between the lower lid and cheek → the shadow disappears. |
| Secondary Benefit (Rejuvenating Effect) | As the lower eyelid volume is reduced, the sub-lash fat pad (aegyo-sal) that was previously obscured becomes naturally visible. Where shadow once fell, light now reflects — and the pigmentation that previously looked so dark beneath the shadow becomes virtually imperceptible and can be covered easily with makeup. |
| Limitations — Important to Know | This procedure reshapes the underlying structure rather than excising skin or muscle. Therefore, in patients with significant age-related skin laxity, fine lines that were previously hidden may become visible after surgery, or the skin may appear to sag slightly. In such cases, lower blepharoplasty is recommended. |
| For Further Brightening of Pigmentation — Laser Toning Option | Because this procedure does not directly eliminate pigmentation, patients in whom pigmentation remains noticeable after surgery, or who wish to achieve further brightening at the source, may combine the procedure with laser toning treatment. |
Procedure Selection by Age Group — Mid-30s as the Turning Point
The degree of skin laxity determines whether a transconjunctival approach alone is sufficient or whether lower blepharoplasty (external incision) is required.
Transconjunctival Under-Eye Fat Repositioning
In many cases (individual variation applies), the transconjunctival fat repositioning alone provides sufficient correction. With minimal skin laxity at this stage, reshaping the underlying structure alone yields excellent results. No external scarring.
Transconjunctival or Lower Blepharoplasty (depending on patient condition)
The decision is made based on the degree of skin laxity and the presence of fine lines. If laxity is minimal, the transconjunctival approach is sufficient; if excess skin is present, lower blepharoplasty (incision method) should be considered.
Lower Blepharoplasty Recommended
Skin excision and fat repositioning should be performed together to address sagging, fine lines, and dark circles simultaneously. The transconjunctival approach alone has limitations at this stage.
※ An incision is rarely made solely for fat repositioning. If an incision is required, the procedure is performed as lower blepharoplasty.
Eye Surgery Procedures — At a Glance
The right method depends on lid thickness, sagging, eye proportion, and revision needs.
| Procedure | Area | Time | Anesthesia | Recovery | Key Technique |
|---|---|---|---|---|---|
| Natural Adhesion Double Eyelid Natural Adhesion | Upper eyelid (double-fold line) | 30 minutes | IV Sedation / Local | From day 3–4 | Micro-tunnel + natural adhesion |
| Incision Double Eyelid Incision Method | Upper eyelid (skin/muscle/fat) | 1 hour | IV Sedation / Local | From 1 week post-op | Incision + tissue trim + line fixation |
| Canthoplasty Canthoplasty | Medial / lateral / lower canthus | 30 minutes | Local / IV Sedation | From 1 week post-op | CPF anchoring + skin redraping |
| Ptosis Correction Ptosis Correction | Upper eyelid (levator muscle) | 1 hour | IV Sedation | From 1 week post-op | Levator strengthening |
| Under-Eye Fat Repositioning Under Eye Fat Repositioning | Lower eyelid (conjunctiva/fat) | 30 minutes – 1 hour | IV Sedation | From 1 week post-op | Conjunctival fat repositioning |
| Revision Eye Surgery Revision Eye Surgery | Eye revision | 1–2 hours | IV Sedation | 2 weeks or more | Adhesion release + redesign |
Click a row to open that procedure.
The AVA Difference
Natural Adhesion Technique
Tissue is repositioned along natural planes and secured at multiple points.
Designed to reduce loosening and align with the patient's intrinsic contour.
Levator Aponeurosis Ptosis Correction
Ptosis is addressed by shortening and refixing the levator aponeurosis,
restoring natural eyelid flow.
Patient Satisfaction Defines Completion
Surgery is complete not when sutures are removed,
but when the patient smiles in front of the mirror.
Q&A
Post-op Instructions
- Do not rub the surgical area strongly for about a week.
- Avoid alcohol and smoking for at least 2 weeks as they delay recovery.
- Swelling and bruising vary individually but will gradually improve.
- Light walking or stretching helps reduce swelling.
Curious About This Procedure?
Our head surgeon provides a one-on-one assessment and a tailored treatment plan just for you. Results and recovery may vary by individual.