Lower Eyelid Fat Repositioning vs. Lower Eyelid Fat Removal: Which Should You Choose?

Hello.

This is April 31 Plastic Surgery.

If you are concerned about hollow under-eyes or dark circles,

you may be considering lower eyelid fat repositioning

or lower eyelid fat removal.

Today, we’d like to take some time to look at

the differences, pros, and cons of these two surgeries.

What are lower eyelid fat repositioning and lower eyelid fat removal?

What is the difference?

April 31 Plastic Surgery: Lower Eyelid Fat Repositioning vs. Lower Eyelid Fat Removal

As an eye surgery to improve a somewhat tired-looking impression,

the upper eyelid has

an eye-opening correction procedure → eye opening correction surgery

and a procedure that adds volume to hollow eyelids → eyelid volume-up surgery.

For the lower eyelid,

there is lower eyelid fat repositioning

and lower eyelid fat removal.

Lower eyelid fat repositioning

releases the tear trough ligament, which is the hollow area under the eyes,

and pulls the orbital fat downward

to fill in the sunken area,

literally repositioning it to a new location.

Lower eyelid fat removal surgery

is performed when orbital fat pushes against the septum

and creates a bulging appearance,

by partially removing the protruding excess fat.

In some cases,

the two procedures are combined.

In some cases, repositioning is performed while also removing part of the fat.

Because it cannot be said that one of these surgical methods

is overwhelmingly superior,

it seems best to determine the appropriate surgery based on each patient’s eye condition,

after customized consultation.

These two procedures share the advantage of improving under-eye puffiness and dark circles,

but there are also some differences in their pros and cons.

The ability to fill in the sunken tear trough area

is an advantage of lower eyelid fat repositioning,

while the relatively wide dissection area required

can be a disadvantage.

On the other hand, lower eyelid fat removal

has the advantage of allowing surgery to be performed more minimally,

with relatively less dissection.

However, for people with deep tear troughs,

this area may be difficult to improve,

which can be a disadvantage.

What type of procedure is right for me?

April 31 Plastic Surgery: Lower Eyelid Fat Repositioning vs. Lower Eyelid Fat Removal

For people with a deep tear trough,

even if lower eyelid fat removal is performed,

repositioning is often helpful.

However, for people with a large amount of under-eye fat,

if the dissection area is made too large for repositioning,

the dissected under-eye fat may instead appear to sag.

In that case, if the dissection area can be kept somewhat narrower,

it is worth considering performing surgery with lower eyelid fat removal alone.

Are there cases where hollow under-eyes or dark circles

are not resolved with lower eyelid fat repositioning alone?

April 31 Plastic Surgery: Lower Eyelid Fat Repositioning vs. Lower Eyelid Fat Removal

There are many different reasons for dark circles.

For people whose dark circles were severe due to the shadow created by

the height difference between under-eye puffiness and the hollow tear trough,

we think they may experience a dramatic change after surgery.

However, if dark circles are present because the skin is thin and the red color of the orbicularis oculi muscle just beneath the skin shows through,

or if there is pigmentation in the skin itself,

dark circles may not be resolved with lower eyelid fat repositioning.

In such cases, it is better to combine surgery

with procedures that strengthen the skin layer

or laser treatment for pigmentation.

The most reliable way to find out

what kind of eye condition you have

and what surgery or procedure may be needed

is to meet with a board-certified plastic surgeon

and receive a diagnosis.

After lower eyelid fat surgery,

is there a chance of recurrence?

April 31 Plastic Surgery: Lower Eyelid Fat Repositioning vs. Lower Eyelid Fat Removal

It would be nice if we could live our entire lives looking young and beautiful,

but realistically, that is difficult.

As we age, due to changes in orbital volume,

changes in the shape of the orbital bone,

reduced elasticity of the septum and skin,

and sagging of facial tissue,

even after orbital fat has been removed or repositioned,

the under-eye bulging may reappear,

or the boundary of the tear trough may look sunken again.

Minor issues that appear after the first surgery,

when the correction has otherwise been done well,

can usually be corrected with a simple method such as fat grafting.

However, if the cause is the relative hollowness caused by sagging tissue in the under-eye area or midface,

lifting surgery such as a midface lift should also be considered.

In particular, during surgery, after opening the septum to remove the fat,

taking care to properly manage the septal area

can help prevent recurrence.

At April 31 Plastic Surgery,

when necessary, we remove fat through an incision as small as possible

and also perform high-frequency stimulation during surgery

to tighten the septum.