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What is eyelid fat removal?

The eyelids contain a structure called "orbital fat."

When there is only an appropriate amount of orbital fat, it helps maintain the contour of the eyelids,

protects the eyeball,

and acts as a lubricant for eyelid movement. But if there is too much,

the lower eyelids or upper eyelids can protrude and look puffy.

When the upper or lower eyelids are thick,

it is often caused by excess orbital fat.

Eyelid fat removal is the procedure that removes excess fat.

It is a fat-removal surgery designed to improve a puffy-looking eye area into a normal contour.

Types of fat removal

Under-eye fat removal

The lower eyelid usually contains three fat pads: one on the inner side of the eye, one in the middle, and one on the outer side.

Among them, the middle fat pad is the largest, so the middle fat is removed, or depending on the case, the middle and inner fat may also be removed.

If needed, the middle and inner fat may be removed together.

How many areas of fat to remove and how much to remove depends on the individual, so it is important to remove an appropriate amount for each person.

Removing too much fat can instead cause hollowness under the eyes, so it is important to remove an appropriate amount after an accurate examination.

● Indications for under-eye fat removal

1. A protruding under-eye shape caused by forward displacement of orbital fat

2. Frequent morning puffiness under the eyes

3. A sunken wrinkle line visible below the protruding under-eye area

4. Red dark circles under the eyes

Upper eyelid fat removal

The upper eyelid usually contains two fat pads: one on the inner side of the eye and one on the outer side.

The outer fat is about twice the volume of the inner fat, so in most cases the general method is to remove the outer fat.

● Indications for upper eyelid fat removal

1. Eyelids that look puffy

2. Eyelids that swell easily in the morning

3. A feeling of heaviness in the eyelids

4. When you want to remove only the fat without affecting the double eyelid line

Effects of fat removal

● It can correct puffy eyelids.

● In the case of under-eye fat removal, it can restore a smoother eye area and correct hollow wrinkle lines under the eyes.

● It can improve red dark circles under the eyes.

● It restores a younger-looking eye area.

Anatomy of under-eye fat

Surgical process for under-eye fat removal

1. The design ink is used to mark the location of the fat. In most cases, the inner and middle areas are marked, and in some cases only the middle area is marked.

Depending on the distribution and amount of fat, the areas to be removed are determined and designed.

2. Anesthesia is performed under sedation with local anesthesia, and because the anesthesia is done while the patient is asleep, it can be administered without pain.

3. To protect the eyeball, a corneal shield is placed, and an incision is made in the conjunctiva with an electrocautery device.

Laser may also be used, but because laser has a weaker hemostatic effect and can cause significant bleeding during surgery, electrocautery is generally used more often.

Electrocautery can minimize swelling and bruising by reducing bleeding.

4. After the incision, when the fat is exposed, it is pulled outward with forceps so that only the amount to be removed comes out.

Excessive fat removal can cause hollowness and wrinkles under the eyes, so it is appropriate to remove only the amount that comes out when pulled.

5. Hemostasis is performed with electrocautery to ensure thorough bleeding control.

If hemostasis is insufficient, bleeding may occur from inside after surgery, causing significant swelling and bruising, so good hemostasis is important.

6. After all the fat has been removed, the conjunctiva is closed with dissolvable sutures.

The dissolvable sutures disappear within 7 to 15 days, so there is no need to return for suture removal.

Contact lenses can also be worn starting the day after surgery.

7. The surgery takes about 20 to 30 minutes and ends quickly. If hemostasis is good and the surgery ends without bleeding, it is common to have little to no swelling or bruising.

After surgery, antibiotic and anti-inflammatory eye drops are used to help prevent swelling and inflammation.

Examples of under-eye fat removal

Aftercare after under-eye fat removal

● Apply the cold compress pack provided by the hospital for about 3 days after the procedure.

● On the day of surgery, sleep with your head elevated at about 30 degrees to reduce bruising and swelling.

● To reduce swelling and bruising, avoid lying down and stay seated as much as possible on the day of surgery.

● Washing your face and makeup are allowed starting the next day.

● Contact lenses may be worn starting the day after surgery.

● Use the eye drops prescribed by the hospital for about a week.

● Since the conjunctiva is closed with dissolvable sutures, there is no need for suture removal.

● Swelling and bruising are usually mild and subside almost completely in about a week.

Precautions for under-eye fat removal

● Excessive fat removal can make the area under the eyes hollow, so care must be taken not to remove too much fat.

● If the skin is loose and under-eye fat removal is performed, the skin may sag and more wrinkles may appear.

● If you have had LASIK, there should be at least a 3-month interval before under-eye fat removal. If you have had LASEK, there should be at least a 1-month interval before under-eye fat removal.

● Under-eye fat removal may worsen dark circles in some cases, so if there is a possibility of worsening dark circles, the procedure should not be performed.

Side effects of under-eye fat removal

The most common side effects include cases where the surgeon misjudges the amount of fat due to lack of experience, resulting in hollowing under the eyes from excessive fat removal, cases where fine wrinkles increase compared to before surgery, and cases where dark circles appear or worsen.

It is better not to have cosmetic procedures at dermatology clinics or other departments that are not run by a board-certified plastic surgeon, especially if they have limited experience.

If hollowing under the eyes occurs after excessive fat removal, it can be corrected and restored with microfat grafting.

To prevent side effects, it is important to determine the indications for fat removal accurately before surgery and remove an appropriate amount of fat under a precise examination.

If there is poor skin elasticity and a tendency for fine wrinkles, or if dark circles may worsen or appear, fat removal should not be performed.

To avoid side effects, the rule is not to undergo surgery from a non-specialist in plastic surgery.

Color changes under the eyes after fat removal

Depending on the skin type under the eyes, there are roughly three types of color change after fat removal.

There may be almost no color change, the color may become slightly darker, or it may become lighter.

If there are dark circles under the eyes, the color often becomes darker after fat removal.

Conversely, if the color is red, the redness may decrease.

Depending on the skin type and the current color, the color change after fat removal should be predicted in advance and addressed appropriately.

If fat removal is performed for the purpose of improving dark circles, it may actually worsen them, so the indications for the procedure must be carefully determined.

In some cases where fat is removed to improve dark circles, additional fat grafting may later be needed beneath the area where fat was removed.

Correction through under-eye fat repositioning

This refers to moving the protruding orbital fat under the eyes to a lower area instead of removing it, and spreading it there.

This is a method intended to correct both the protruding area and the hollow area at the same time.

It was devised to address the limitation that fat removal can solve the protrusion but cannot correct the hollow area.

Problems with under-eye fat repositioning

The problem with under-eye fat repositioning is that it is difficult to achieve the desired results properly.

Because the surgery is performed through the conjunctiva, the field of view is limited, making the surgery difficult to perform properly, and there are not many patients for whom fat repositioning is ideally suited to produce good results.

As an easy example, if there is land with a pit and a hill, and the goal is to level everything by removing soil from the hill to fill the pit, then if the hill is not very large, even after cutting away all of the hill soil, it may still not be enough, and after filling the pit, the hill area may instead become a depression.

This is the strange phenomenon in which, when fat is forcibly pulled and repositioned in a situation where there is not much fat, the previously protruding area ends up sunken.

In another case, the pit is larger than the hill, so even after removing all the hill soil to fill the pit, the depth of the pit becomes only slightly shallower and it still remains a pit.

This refers to a case where a small amount of fat is pulled and repositioned, but the hollow area is not corrected well and remains hollow.

In yet another case, the hill is large, so even after filling the pit completely, the hill only becomes a little smaller and still remains a hill.

This refers to a case where there is so much protruding fat that even after repositioning, some fat remains and the under-eye protrusion is still present.

Four types of dissatisfaction with under-eye fat repositioning

1. When there is not enough fat, the area that originally protruded where the fat was may instead become sunken after fat repositioning

2. When there is a large amount of fat, the original protruding area may still look protruded even after fat repositioning

3. After fat repositioning, the original hollow area may instead look protruded

4. When there is only a small amount of fat, the original hollow area may not be filled properly after fat repositioning and may still look sunken and shadowed

Therefore, when performing fat repositioning, surgery must be done by carefully determining the proper shape and indications in order to achieve satisfactory results. If the case is not appropriate for fat repositioning, the procedure may end up being neither one thing nor the other.

Also, because more tissue must be dissected than with fat removal, swelling and bruising are much more severe.

If the indications are not suitable, fat removal can provide a more definite result than fat repositioning, and if necessary after fat removal, microfat grafting can additionally be performed to fill the hollow area.

Proper knowledge about under-eye fat removal

● When fat removal is performed with a laser

There are hospitals that perform fat removal with a laser, but there is something you should know.

Some people mistakenly think of laser as a universal and best surgical method.

The problem with laser incision during under-eye fat removal is that there is a lot of bleeding after the incision.

The heat generated by the laser can naturally stop bleeding from fine capillaries, but slightly larger blood vessels do not stop bleeding, so if the surgery is done only with a laser, the bleeding can prevent the surgery from being performed at all.

If surgery is done with a laser, it must be performed using an electric coagulator.

If there is bleeding, the laser should be stopped and surgery should continue while controlling bleeding with an electric coagulator.

There is absolutely no reason to perform the surgery this way.

If the surgery is performed from the beginning using an electric coagulator, hemostasis is achieved properly and the surgery can proceed more quickly.

Despite several disadvantages, some hospitals still use lasers.

It is simply to gain promotional effect for the hospital through the word "laser."

The aim is to make it seem like surgery would be better with a laser and to encourage purchasing intent.

The laser used for fat removal is a carbon dioxide laser for incision.

In the case of pigment lasers used to remove Ota's nevus or tattoos, they can cost tens of millions of won, but a carbon dioxide laser is one of the least expensive lasers and is usually used to remove moles, freckles, and age spots.

Just because a hospital has a carbon dioxide laser does not mean it has especially expensive equipment.

You should understand it as basic equipment that all plastic surgery and dermatology clinics have.

Our clinic also has a carbon dioxide laser, and we mainly use it only for removing moles and age spots.

It is not used for surgery.

● When fat removal plastic surgery is performed in a dermatology clinic

Sometimes plastic surgery is performed in a dermatology clinic rather than in a plastic surgery clinic.

Dermatology is a department that treats skin diseases.

It is a field that has nothing to do with plastic surgery.

Sometimes people confuse dermatology with plastic surgery.

Dermatology can be thought of like internal medicine.

Internal medicine treats colds and internal diseases of the body with medication, and dermatology also treats skin diseases with medication.

A dermatologist performing plastic surgery with a scalpel is no different from an internal medicine doctor picking up a scalpel.

It is common for people to come to our clinic for correction after excessive fat removal and side effects from procedures performed in dermatology clinics.

In such cases, we correct the problem again with microfat grafting, but these side effects should not be created in the first place.

As the saying goes, "Medicine is for pharmacists, treatment is for doctors," plastic surgery should be entrusted to a plastic surgery specialist.

● Fat removal for improving dark circles

The main purpose of under-eye fat removal surgery is to correct the protruding contour under the eyes.

It is not a surgery whose primary goal is to change the color under the eyes.

In most cases, when fat removal is performed, the skin color changes due to skin contraction, but if too much fat is removed, the under-eye area becomes hollow and may look even darker.

Fat removal aims to remove an appropriate amount of fat and create a smooth eye area.

The color change after fat removal varies by person, but there are not many cases where the color becomes brighter.

If the under-eye skin is thin and the red muscle layer beneath shows through, giving a reddish appearance, fat removal may reduce the redness.

However, in other cases, the color may become darker, so this should be kept in mind during surgery.

It is important to predict in advance the color change after fat removal before surgery to avoid problems afterward.

FAQ about under-eye fat removal

Question) What is the best method for under-eye fat removal?

Answer) Under-eye fat removal does not involve making an incision in the skin.

If an external incision is made, a scar remains, so in most cases a scar-free procedure through the conjunctiva is performed.

Question) How much swelling and bruising occurs after fat removal?

Answer) There will be some swelling and bruising, but they will almost disappear in about a week.

Question) Do the stitches need to be removed?

Answer) Since the fat is removed through an incision in the conjunctiva and closed with dissolvable sutures, there is no need to remove stitches.

Question) Does the fat come back?

Answer) Once removed, fat does not regenerate.

Fat removal has a permanent effect.

Upper eyelid fat anatomy

Surgical process for upper eyelid fat removal

1. Mark the outer side of the eyelid with a design pen.

If there is a double eyelid, the design is made along the double eyelid line.

2. Local anesthetic is injected.

Even a small amount is enough to achieve anesthesia, so swelling from the anesthetic is minimal.

3. An incision is made with a scalpel along the design line.

The incision is only about 2 to 3 mm long, so there is almost no scar.

In the case of an eyelid with a double fold, the incision line passes through the double eyelid line, so the scar is hidden and not visible.

4. The orbital fat is pulled out.

The fat accumulates in the orbital septum, so the orbital septum must first be removed before pulling out the fat, allowing sufficient fat to come out.

5. The lower end of the protruding fat is grasped with a hemostatic forceps and excised with a scalpel.

6. The remaining fat tissue is cauterized with electrocautery to prevent bleeding from the lower part of the remaining fat.

Good hemostasis is necessary to prevent swelling and bruising.

7. Only one stitch is placed with a fine thread as thin as a strand of hair.

The stitch can be removed after 2 to 3 days.

You can return to daily life immediately after surgery, and it is common to have little to no swelling or bruising.

Examples of upper eyelid fat removal

Aftercare after upper eyelid fat removal

● Apply the cold compress pack provided by the hospital for about 3 days after the procedure.

● Remove the stitches on the second day after surgery.

● Washing your face and makeup are possible starting the next day after surgery.

● Swelling and bruising are mild, so you can return to daily life immediately.

Precautions for upper eyelid fat removal

● If the upper eyelid skin or orbicularis oculi muscle is thick and makes the eyelids look puffy, the effect of fat removal may be limited.

● In eyes that have had double eyelid surgery, upper eyelid fat removal is almost impossible.

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This is the case of performing fat removal with a laser.

There are hospitals that perform fat removal with a laser, but there is something you should know.

Some people mistakenly think of laser as a universal and best surgical method.

The problem with laser incision during under-eye fat removal is that there is a lot of bleeding after the incision.

The heat generated by the laser can naturally stop bleeding from fine capillaries, but slightly larger blood vessels do not stop bleeding, so if the surgery is done only with a laser, the bleeding can prevent the surgery from being performed at all.

If surgery is done with a laser, it must be performed with an electric coagulator.

If there is bleeding, the laser should be stopped and surgery should continue while controlling bleeding with an electric coagulator.

There is absolutely no reason to perform the surgery this way.

If surgery is performed from the beginning with an electric coagulator, hemostasis is achieved properly and the surgery can proceed more quickly.

Despite several disadvantages, some hospitals still use lasers.

It is simply to gain promotional effect for the hospital through the word "laser."

The aim is to make it seem like surgery would be better with a laser and to encourage purchasing intent.

The laser used for fat removal is a carbon dioxide laser for incision.

In the case of pigment lasers used to remove Ota's nevus or tattoos, they can cost tens of millions of won, but a carbon dioxide laser is one of the least expensive lasers and is usually used to remove moles, freckles, and age spots.

Just because a hospital has a carbon dioxide laser does not mean it has especially expensive equipment.

You should understand it as basic equipment that all plastic surgery and dermatology clinics have.

Our clinic also has a carbon dioxide laser, and we mainly use it only for removing moles and age spots.

It is not used for surgery.

Second, cases where fat removal plastic surgery is performed in a dermatology clinic.

Sometimes plastic surgery is performed in a dermatology clinic rather than in a plastic surgery clinic.

Dermatology is a department that treats skin diseases.

It is a field that has nothing to do with plastic surgery.

Sometimes people confuse dermatology with plastic surgery.

Dermatology can be thought of like internal medicine.

Internal medicine treats colds and internal diseases of the body with medication, and dermatology also treats skin diseases with medication.

A dermatologist performing plastic surgery with a scalpel is no different from an internal medicine doctor picking up a scalpel.

It is common for people to come to our clinic for correction after excessive fat removal and side effects from procedures performed in dermatology clinics.

In such cases, we correct the problem again with microfat grafting, but these side effects should not be created in the first place.

As the saying goes, "Medicine is for pharmacists, treatment is for doctors," plastic surgery should be entrusted to a plastic surgery specialist.

Lastly, fat removal for improving dark circles.

The main purpose of under-eye fat removal surgery is to correct the protruding contour under the eyes.

It is not a surgery whose primary goal is to change the color under the eyes.

In most cases, when fat removal is performed, the skin color changes due to skin contraction, but if too much fat is removed, the under-eye area becomes hollow and may look even darker.

Fat removal aims to remove an appropriate amount of fat and create a smooth eye area.

The color change after fat removal varies by person, but there are not many cases where the color becomes brighter.

If the under-eye skin is thin and the red muscle layer beneath shows through, giving a reddish appearance, fat removal may reduce the redness.

However, in other cases, the color may become darker, so this should be kept in mind during surgery.

It is important to predict in advance the color change after fat removal before surgery to avoid problems afterward.

http://www.microfat.net ​