Lower Eyelid Fat Repositioning Guide

Clinical Overview & Guide

Source: Medical Today | Published: May 2025 | Medical Commentary: Dr. Ju-Chan Kim, Chief Medical Director, IBON Plastic Surgery (Seomyeon, Busan).

The periorbital area has thin skin and constant muscle movement, making it one of the first facial regions to show signs of fatigue and aging. When orbital fat beneath the eyes protrudes while the tear trough groove deepens, it creates shadows and dark circles that can make a person appear tired or older than their actual age.

According to Dr. Ju-Chan Kim, Chief Medical Director of IBON Plastic Surgery in Seomyeon, Busan and full member of the Korean Society of Plastic and Reconstructive Surgeons (KSPRS), under-eye fat repositioning (lower eyelid fat repositioning) addresses structural shadowing by redistributing protruding orbital fat into adjacent hollow depressions rather than simply excising fat. These anatomical principles align with craniofacial surgical standards published in Archives of Craniofacial Surgery (ACFS).

Key Principles of Under-Eye Fat Repositioning

1. Balanced Volume Redistribution

• Simply removing under-eye fat can leave the lower eyelid looking hollow or sunken over time.
• Lower eyelid fat repositioning moves excess protruding fat into depressed tear trough areas and secures the orbital septum, creating a smooth contour from the lower eyelid to the upper cheek. Learn more in our clinical guide on how under-eye fat repositioning works.

2. Transconjunctival Approach vs. Lower Blepharoplasty

• When skin elasticity is preserved and there is minimal excess skin, the procedure can be performed through the inner conjunctiva without an external skin incision, minimizing visible scarring and recovery time.
• If significant skin laxity, deep wrinkles, or lower eyelid sagging are present, a middle-age eyelid surgery approach or complementary anti-aging treatment addressing both skin and muscle tension may be recommended instead (see Non-Surgical or Surgical for Aging Eyes: Where the Line Is).

3. Anatomical Precision

• Because lower eyelid skin and septum thickness vary among individuals, an accurate 1:1 consultation evaluating fat compartment volume, tear trough ligaments, and skin tone (Personalized Eye Surgery Consultation: Inside a 1:1 Review) is essential for natural, long-lasting results.