Hello, this is Dr. Song Cheon-Ho, a board-certified plastic surgeon at AB Plastic Surgery in Gangnam, Seoul.

One of the most common concerns among international patients seeking eye surgery in Korea is prominent or sunken under eye fat, which can create dark circles and a tired or aged appearance.
In this column, I will explain which type of eye surgery is most appropriate for under eye fat concerns, based on anatomical condition and aging patterns.

 Q. My under eye fat looks prominent. Which procedure do I need?

Under eye fat plays an important role in protecting the eyes. However, when orbital fat becomes excessively protruded or displaced, it can emphasize dark circles and make the face look fatigued or older than its actual age.

One of the most effective solutions is under eye fat repositioning surgery.

What is Under Eye Fat Repositioning?

Under eye fat repositioning is a surgical procedure that:

• Redistributes bulging orbital fat

• Fills sunken tear troughs

• Creates a smoother and more natural under eye contour

This procedure is commonly recommended for patients in their 20s to 30s, as well as those in their early 40s with good skin elasticity.

Since under eye anatomy varies significantly, customized surgical planning is essential. A thorough consultation with a qualified plastic surgeon is required to determine the most suitable method.

[CASE 01]

How Does the Transconjunctival Approach Work?

When under eye bulging and shadowing are caused by orbital fat, correction can be effectively achieved using a transconjunctival approach.

Procedure Overview

• Access is made through the inside of the lower eyelid (no visible external scar)

• The tear trough ligament is carefully released

• Protruding fat is repositioned downward to fill hollow areas

• Minimal fat removal may be performed if necessary for balance

This approach improves both bulging and shadowing simultaneously, resulting in a more youthful and refreshed appearance.

[CASE 02]

When Is Orbital Septum Reinforcement Needed?

If sagging orbital fat is accompanied by:

• Deep tear troughs

• Pronounced under eye wrinkles

• Weakened tissue support

Then under eye fat repositioning combined with orbital septum reinforcement may be recommended.

Surgical Benefits:

• Partial removal of elongated fat

• Even redistribution for natural volume

• Reinforcement of the orbital septum to prevent recurrence

• Improved firmness and long-term stability

Recovery Period:

• Initial swelling and bruising: ~7 days

• Full recovery: 1–2 weeks

• Most patients return to daily activities relatively quickly.

Q. What Is the Difference Between Under Eye Fat Repositioning and Fat Grafting?

If the tear trough is deep without protruding orbital fat, fat grafting may be the better option.

Key Differences
 

Choosing the correct procedure depends on fat distribution, skin elasticity, and aging pattern.

Q. Can Under Eye Fat Become Prominent Again After Surgery?

Under eye fat repositioning is a highly precise and durable procedure, and results are generally long-lasting.

However, recurrence may occur over time due to:

• Natural aging

• Skin elasticity changes

• Individual healing response

To maintain optimal results:

• Follow proper postoperative care

• Attend regular follow-up consultations

• Consider supplementary treatments if needed

 For detailed consultation:

Tel:  +82 10 9674 1298

WhatsApp +82 10 9674 1298

Writer Dr. Song Cheon-Ho, AB Plastic Surgery