Under-Eye Fat Repositioning

Lower blepharoplasty (under-eye surgery) improves the under-eye fat and dark hollows that make the lower lid look tired. Rather than only removing fat — which can leave the area sunken — the herniated fat is repositioned into the tear-trough hollow, smoothing the transition from lid to cheek. When the skin is still firm this is done from the inside, without a skin incision; where there is loose skin, a fine lash-line incision allows gentle tightening as well.

You might consider a consultation if you have under-eye bags that cast a tired shadow, dark hollows or tear-troughs unrelated to pigment, or a lid-to-cheek step that make-up settles into. Anyone wanting a refreshed look without an operated appearance can also have their current condition assessed for suitability at the consultation.

We review how much the under-eye fat protrudes, the depth of the tear-trough hollow, the elasticity and looseness of the lower-lid skin, and whether there is pigment or dark circles. These conditions can change whether inside repositioning alone is enough or whether skin tightening or grafting is needed. Dark circles and pigmentation are also assessed.

Transconjunctival repositioning moves fat from inside the lid, without a skin incision — suited to good skin tone. Where skin is loose, a “fat repositioning + skin” approach adds gentle tightening through a fine lash-line incision. If a hollow remains, grafting refinement with a little fat or filler can smooth the lid-to-cheek line. Which method suits you is decided at the consultation according to your under-eye condition and goal.

In general it proceeds as analysis of facial proportion and under-eye condition, bespoke design, anaesthesia, fat repositioning, and recovery with follow-up. At Cejong it is done under sedation and usually takes about 40 minutes, though this can vary with the extent of surgery and the individual.

Downtime is about one week; most bruising and swelling settle within one to two weeks and the result matures over one to two months. Cold compresses for the first 72 hours and sleeping with the head elevated for a few nights can help ease swelling. The timing for returning to daily life and the finer course vary from person to person. Washing is possible after about 5–7 days and make-up after about 7–10 days; light daily activity is possible right after surgery.

Apply cold compresses for the first 72 hours to limit bruising and sleep with the head elevated for several nights. Avoid contact lenses and eye-rubbing for about a month, and keep any lash-line incision clean and out of the sun. Attend follow-up so smoothness and symmetry are checked, and if anything unusual appears, contact the clinic rather than judging it yourself. We advise avoiding smoking for about 2–4 weeks, alcohol for about 2 weeks, and sauna and strenuous exercise for about 4 weeks.

As with any surgery, lower blepharoplasty carries possible side effects such as swelling, bruising, infection, asymmetry, and temporary lower-lid pull or eversion, and their degree and course differ between people. It is important to be fully informed about the possible risks and how they are managed at the consultation.

Lower blepharoplasty treats the under-eye fat and hollow of the lower lid — a different area from upper blepharoplasty, which improves drooping of the upper lid. “Under-eye fat repositioning” refers to the approach within lower blepharoplasty of moving fat into the hollow rather than removing it, so the two overlap greatly. The suitability of each is judged at the consultation based on your current under-eye, and you can see each page under “Related content” below.

Lower blepharoplasty improves the under-eye fat and dark hollows that make the lower lid look tired. It repositions the protruding fat into the tear-trough and, if needed, refines loose skin, aiming for a smooth line from lid to cheek.

Under-eye fat repositioning is a term for the method, within lower blepharoplasty, of moving fat into the hollow rather than removing it. It is not a separate operation but one way of performing lower blepharoplasty, considered especially when the under-eye fat protrudes.

As the structures supporting the lower lid weaken with age, the fat behind them can push forward and appear to protrude. Genetic factors and changes in skin or muscle elasticity can also contribute, so the cause and degree are assessed at the consultation.

Downtime is usually about one week; bruising and swelling settle over one to two weeks and the result matures over one to two months. Cold compresses and keeping the head elevated for the first few days can help, and the course varies from person to person. Washing is possible after about 5–7 days and make-up after about 7–10 days.