Lower Eyelid Fat Repositioning

Lower Eyelid Fat Repositioning Overview

Medically reviewed and performed by Dr. Ju-Chan Kim, Chief Medical Director of IBON Plastic Surgery (Board-Certified Plastic Surgeon, Korean Society of Plastic and Reconstructive Surgeons (KSPRS)).

Lower eyelid fat repositioning at IBON Plastic Surgery—our signature procedure under Under-Eye Fat Repositioning—corrects protruding under-eye fat pads and hollow tear troughs simultaneously. Performed personally by Dr. Ju-Chan Kim, Board-Certified Plastic Surgeon, the procedure accesses the fat compartments through the inner conjunctiva without an external skin incision, moving excess orbital fat into depressed grooves and reinforcing the orbital septum for smooth, lasting lower-lid support in accordance with oculoplastic principles published in Archives of Craniofacial Surgery (ACFS).

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Why Reposition Instead of Only Removing?

Simply removing orbital fat can leave the under-eye area looking sunken or accentuate tear trough shadows over time. By repositioning protruding fat across the tear trough ligament and securing the septal structure, the transition between the lower eyelid and upper cheek becomes level and balanced. For a detailed anatomical breakdown, read our article on How Under-Eye Fat Repositioning Works. When significant lower-eyelid skin laxity is also present, patients may compare Middle-Age Eyelid Surgery options or read Non-Surgical or Surgical for Aging Eyes: Where the Line Is.

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Clinical Specifications & Surgical Summary

Parameter	Clinical Specification
Surgical Access	Internal transconjunctival approach inside the lower eyelid (no external skin incision)
Core Mechanism	Release of the tear trough ligament, pedicled orbital fat transposition, and septal reinforcement
Anesthesia	Local anesthesia with brief monitored sedation
Procedure Duration	Approximately 30–60 minutes
Suture Removal	None required (internal mucosal approach)
Return to Daily Routine	Approximately 3–5 days

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Ideal Candidacy & Clinical Benefits

• Patients with protruding under-eye bags accompanied by a sunken tear trough groove that casts a dark shadow beneath the eyes.
• Patients whose dark circles are caused by structural fat herniation and shadowing rather than superficial skin pigmentation alone (for fine skin elasticity, complementary Rejuran & Rejuran HB or Skin Boosters can be considered).
• Patients with good lower eyelid skin elasticity who do not require external skin excision.
• Preserves the intact orbicularis oculi muscle and natural pretarsal roll (aegyo-sal) while preventing postoperative under-eye hollowness.

Step-by-Step Clinical Process & Recovery Timeline

• Anatomical Fat & Groove Mapping: Dr. Ju-Chan Kim marks the protruding medial, central, and lateral fat compartments and the exact path of the tear trough depression while the patient is seated upright during a 1:1 consultation.
• Transconjunctival Release: Through an internal conjunctival incision, the tight retaining ligament along the orbital rim is released to create a smooth recipient pocket.
• Pedicled Fat Transposition & Septal Fixation: Protruding orbital fat is spread evenly over the orbital rim hollow and secured to prevent relapse.
• Recovery & Follow-Up: Because there is no external skin incision, swelling settles steadily over 3–7 days without external stitch removal.

Post-Procedure Precautions & Clinical Disclosure

• Apply cold compresses during the first 48–72 hours, sleep with your head elevated, and avoid bending forward or heavy lifting for 2 weeks.
• Refrain from rubbing the lower eyelids, wearing contact lenses, swimming, drinking alcohol, or smoking for 2–3 weeks after surgery.
• Clinical Disclosure: Depending on individual anatomy and healing response, potential post-procedure effects such as bleeding, infection, inflammation, temporary swelling, bruising, conjunctival edema (chemosis), transient double vision, or mild contour asymmetry may occur and are explained in detail during your 1:1 consultation.

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Frequently Asked Questions

Q. Does Lower Eyelid Fat Repositioning affect my natural pretarsal roll (aegyo-sal)?
A. No. The pretarsal roll is formed by the orbicularis muscle immediately below the eyelashes, whereas fat repositioning addresses the deeper orbital fat pads below the roll. Removing the protruding bag beneath it often makes the natural pretarsal roll look cleaner and more defined.

Q. How long do the results of Lower Eyelid Fat Repositioning last?
A. Because the herniated fat is transposed across the released tear trough and the orbital septum is reinforced, structural improvement is long-lasting compared with temporary filler camouflage, though natural facial aging continues over time.