Under-Eye Fat Repositioning 101: Benefits, Transconjunctival Technique, Recovery & Precautions

Hello, I am Dr. Seungsoo Kim, Director and Board-Certified Plastic Surgeon at AVA Plastic Surgery in Sinsa, Seoul.

For patients troubled by tired-looking, puffy under-eye bags or persistent dark shadows, under-eye fat repositioning is one of the most rewarding procedures we perform. Today, I will walk you through its anatomical principles, ideal candidates, surgical technique, recovery timeline, and key precautions.

What Is Under-Eye Fat Repositioning?

As we age, the orbital septum—the fibrous membrane holding intraorbital fat in place—gradually weakens. Fat herniates forward to form a bulge while casting a deep tear-trough shadow directly beneath it. Rather than discarding this valuable fat, under-eye fat repositioning redistributes it downward into the sunken tear trough, simultaneously flattening the bag and cushioning the hollow.

Because the procedure is performed via a transconjunctival approach (through the inner lining of the lower eyelid), there are no external skin incisions, no surface sutures, and no visible scars.

Who Is an Ideal Candidate?

• Patients whose protruding under-eye bags create a chronically tired or aged expression
• Patients with both under-eye puffiness and sunken, shadowed tear troughs
• Patients with good lower-lid skin elasticity who want scarless rejuvenation (patients with significant loose skin are better suited for lower blepharoplasty)

Surgical Technique & Recovery Timeline

Herniated orbital fat pads are delicately mobilized after releasing the tethered tear trough ligament and secured across the sub-orbital hollow to create a smooth transition from the lower lid to the mid-cheek.

• Swelling & Bruising: Major swelling subsides within 1 to 2 weeks, with fine tissue settling continuing over the following months.
• Daily Routine: Most patients return to normal daily activities within a few days, with no external stitches to remove.

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📍 AVA Plastic Surgery · 4F Insung Building, 603 Gangnam-daero, Seocho-gu, Seoul (1-min walk from Sinsa Station Exit 4) · TEL +82 2-545-1882
※ Surgical Notice: Post-operative complications such as bleeding, infection, swelling, scarring, asymmetry, or sensory changes may occur, and results and recovery vary by individual.