Can lower blepharoplasty fat repositioning be revised?

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[Revision Surgery] Orbital Septum Lower Blepharoplasty Under-Eye Fat Repositioning

Many patients who previously underwent lower blepharoplasty fat repositioning come to our hospital after the problem recurs.

At this time, many people say, “I heard lower blepharoplasty fat repositioning cannot be revised.” However, in reality, revision surgery is not impossible. Whether surgery is possible is determined by the amount of skin laxity and the amount of fat remaining.

The non-incisional transconjunctival approach is possible for younger patients with good skin elasticity, but it may not fundamentally solve structural sagging or fat descent. As a result, hollowness or imbalance may reappear over time, and under-eye fat may start to recur.

Because the method through the conjunctiva offers limited visibility of the surgical area, access to the fat layer is difficult. If the fat has descended deeply or in severe cases, access to the fat layer is practically difficult. In revision surgery, internal damage is severe and the tissue is compromised, so an incision is essential.

Reasons revision surgery is difficult

Lower blepharoplasty revision surgery often looks very different from the outside compared to the internal condition. In many cases, the previous surgical method cannot be confirmed precisely, and internal adhesions or scar tissue are severe, making the surgery more difficult. In addition, the revision method changes depending on what was done in the previous surgery, so a step-by-step approach is necessary, and the degree of difficulty and cost vary accordingly.

3 months after revision surgery for reinforced-septum lower blepharoplasty under-eye fat repositioning

Reasons an incision is needed in revision surgery

In revision patients, the fat has already been partially removed or damaged, and in some cases the fat and muscle layers are clumped together due to fillers or fat grafting. It is also common to feel hard or uneven scar tissue when pressing on the area. In such complex situations, securing a sufficient field of view is more important than anything else. By making an incision just below the eyelashes, the surgical range can be widened so that the fat layer and scar tissue can be safely accessed, and an incisional approach is advantageous for reconstructing or repositioning damaged fat pads.

The process of lower blepharoplasty revision

Revision surgery begins with a wide exposure of the descended fat compartment through an incision below the eyelashes. If necessary, the fat is refined or repositioned, and the weakened orbital septum is reinforced to improve fat stability. If the skin is stretched, an appropriate amount is removed to improve fine wrinkles and sagging. In addition, the midface (SMAS layer and orbicularis oculi muscle) tissue is pulled upward and fixed to the periosteum to fundamentally address midface sagging. Finally, the procedure is completed with delicate suturing to ensure both natural appearance and stability of the eyes.

Why midface lifting is important in revision surgery

Problems under the eyes are not simply a matter of fat alone. When the muscles and soft tissue of the midface, which support the center of the face, weaken, fat moves downward or the eyelid is pulled downward. By lifting and fixing the midface together, ectropion can be prevented, tear troughs and hollowness can improve, the chance of recurrence can be reduced, and results can remain stable for a longer period. In particular, this process is essential for revision patients whose structure has already weakened.

Before-and-after comparison of tear trough surgery

Anseongmin Plastic Surgery’s revision surgery approach

Anseongmin Plastic Surgery has focused exclusively on upper and lower eyelid surgery and revision surgery for a long time, and specializes in complex cases such as aftereffects from surgery at other hospitals, trauma, and congenital problems.

Director An Seong-min makes it a principle to accurately diagnose the fundamental cause in the lower eyelid area and choose only the minimum necessary procedures. He also considers it most important to help patients understand why the procedure is necessary for them.

Before and after surgery

Revision surgery is determined by “precision” above all else

There is no fixed formula for lower blepharoplasty revision surgery.

Because each patient has a different anatomical structure, scar pattern, and degree of previous damage, thorough analysis and meticulous planning are necessary.

The ability to produce predictable results comes from extensive clinical experience.

Based on this experience and skill, Anseongmin Plastic Surgery

aims to provide the safest and most natural results.

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