Laser Under-Eye Fat Repositioning: Encore UltraPulse for a More Stable Procedure

1. Why Under-Eye Fat Bulges Out

Under-eye fat does not simply increase in volume. As we age, the orbital septum and surrounding tissues that support the fat weaken, allowing the fat to move forward and appear bulged.

2. Why It Becomes More Noticeable Starting in Your 40s

After the age of 40, decreased skin elasticity, weakening of the orbicularis oculi muscle, and changes in the tear trough and midface volume can occur together, making the boundary between under-eye fat and hollowness more distinct.

3. What Is Laser Under-Eye Fat Repositioning?

This procedure accesses the area through the conjunctiva on the inside of the eye, adjusts the protruding fat, and repositions it where needed. One characteristic is that it can be performed without making an external skin incision.

4. The Role of the Encore UltraPulse CO2 Laser

The laser may be used during the conjunctival incision process to access the tissue precisely and help with hemostasis.

5. The Same Method Is Not Necessary for Everyone in Their 40s.

If skin sagging or wrinkles are severe, under-eye fat repositioning alone may not be sufficient. Therefore, it is important to assess fat protrusion, skin elasticity, the tear trough, and the condition of the orbital septum together before determining the surgical method.

Why do the area under the eyes sag or develop wrinkles as we age? Under-eye fat is originally located inside the eye socket, which is called the orbit. However, as we age, the supporting structures surrounding this fat weaken due to aging, allowing the fat to move outward and bulge.

1. The Biggest Factor: A Weakened Orbital Septum

As we age, the orbital septum surrounding the fat weakens and loses elasticity. A weakened septum is gradually pushed outward by gravity, making it look as though a pouch has formed under the eyes. As a result, the under-eye fat protrudes.

2. Structural Changes Caused by Aging

Tear trough ligament fixation issues: As the ligament that supports the area between the eye and the under-eye region sags or becomes tight, the boundary between the ligament and the fat can become more distinct, making the fat appear more prominent.

Loss of volume: When volume is lost from the cheekbones and the midface, the under-eye fat may appear relatively more prominent.

Decreased muscle and skin elasticity: As the skin around the eyes becomes thinner and the function of the orbicularis oculi muscle declines, the ability to support the fat may also inevitably decrease.

3. Other Causes

Lifestyle-related factors: Insufficient sleep, frequently eating salty foods, drinking alcohol or smoking, and significant exposure to ultraviolet rays may have an impact.

Genetic factors: If other family members have under-eye fat bulging, it may develop at a relatively young age, even if you are not older.

Allergies and rhinitis: It may become more noticeable if you have chronic swelling or frequently rub your eyes.

Sudden weight changes: Sudden weight gain or loss may cause changes in the under-eye fat.

• In your 20s and 30s: It often develops due to genetic and lifestyle-related factors.

• After your 40s: As the skin and muscles begin to sag and the orbital septum weakens, the symptoms may become more noticeable.

To summarize, under-eye fat bulging is not generally caused by an increase in fat. Rather, the septum and surrounding structures that normally support the fat weaken, allowing it to move outward. Therefore, for a successful result, surgery aimed at repositioning the fat and strengthening the septum, rather than simply removing the fat, may be considered to address this structurally related issue.

Laser under-eye fat repositioning addresses under-eye concerns using a laser. Rather than using the scalpel commonly used in conventional surgery, the procedure uses the Encore UltraPulse to make an incision in the conjunctiva and appropriately reposition the fat.

Procedure

A micro-incision is made in the conjunctiva on the inner side of the eye using a laser.

If there is protruding fat, some of it may be removed if necessary. The hollow area known as the tear trough can be treated through repositioning, along with orbital septum reinforcement.

Advantages of Laser Under-Eye Fat Repositioning

• Because it uses a laser, bruising, swelling, and bleeding may be relatively reduced.

• Visible external scarring may also be minimized.

• Because tissue damage is limited, recovery may be relatively faster.

Precautions for Laser Under-Eye Fat Repositioning

• Removing too much fat during surgery may instead result in hollowing.

• Results may vary depending on the surgeon’s skill, experience, and expertise.

• If sagging is severe, under-eye fat repositioning alone may not provide a sufficient result.

In general, the issue of under-eye fat bulging begins in earnest in the 40s. However, because elasticity has not usually declined as severely as it does in older adults, this age group may be suitable for laser transconjunctival surgery. In particular, if there is little sagging for your age, repositioning alone may produce a positive result.

This laser operates on the principle of using a high-powered CO2 laser that is strongly absorbed by the moisture in skin tissue.

• Very short pulse width and high peak power: The same amount of energy can be delivered more efficiently within a shorter period, and delicate irradiation can reduce damage to the surrounding tissue.

• Penetration depth: A single pulse can reach approximately 3.5–4 mm, allowing it to address tissue or deep scars.

Notable Roles in Under-Eye Fat Repositioning

• Because the laser pulses are short, damage to the surrounding tissue may be reduced, potentially shortening recovery time.

• As some thermal energy is delivered to the tissue during surgery, it may also help with skin elasticity.

• Hemostatic effects may be expected, and the precise conjunctival incision may reduce bruising and bleeding.