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SYMPTOMS & DARK CIRCLE SURGERY

Symptoms and Surgical Methods

Dark circles can present with various symptoms, such as sunken areas, under-eye wrinkles, protrusion, dark coloration, blue veins, and more.

The correct surgical method is applied according to which symptom matches your own condition.

DUHAN DARK CIRCLE CLINIC

1. What is under-eye fat repositioning?

It refers to a method in which, instead of removing the orbital fat under the eyes, the protruding fat is moved and spread to the lower depressed area.

This is a method intended to correct both protruding and sunken areas at the same time.

It was developed to address the drawback of fat removal, which can solve protrusion but cannot correct sunken areas.

2. Candidates for under-eye fat repositioning surgery

This is for cases where bulging orbital fat under the eyes is accompanied by protrusion and sunken wrinkles.

3. Advantages of under-eye fat repositioning

① Improvement of dark circles

② Correction of puffy eyelids

③ Prevention of a sunken look that can occur after excessive under-eye fat removal

④ Recovery to a smoother eye area along with correction of under-eye wrinkles

⑤ No visible scar and a natural appearance

4. How under-eye fat repositioning surgery is performed

The loosened fat pouch is removed through the conjunctiva, moved above the bone under the eyes, and fixed so that it does not move.

5. Differences between lower blepharoplasty and under-eye fat repositioning

Lower blepharoplasty	Comparison	Fat repositioning
Incision of the skin under the eyes	Surgical area	Inner conjunctiva of the eye
A slight incision mark remains.	Scar	Almost none
It is removed.	Aegyo sal under the eyes	Maintained or created
Yes.	Wrinkle removal	No
Surgery is not possible.	Whether surgery can be performed on keloid patients	Surgery is possible

6. Problems with under-eye fat repositioning

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

Because the procedure is performed through the conjunctiva, the field of view is limited, so the surgery is not performed properly, and there are not many people who are truly suitable for achieving good results through fat repositioning.

For a simple example, if there is land with a depression and the goal is to level the whole area by scooping soil from a hill to fill the depression, then if the hill is not very large, even after removing all the soil from the hill, there may still not be enough to fill the depression. In that case, after filling the depression, the hill may instead become a sunken pit.

This means that when there is not much fat and it is forcibly pulled and repositioned, the protruding area can paradoxically become sunken.

In another case, the depression may be larger than the hill, so even after removing all the soil from the hill to fill the depression, the depth of the depression is only slightly reduced and it still remains a depression.

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

In yet another case, the hill may be large, so even after filling the depression, the hill only becomes slightly smaller and still remains a hill.

This refers to a case where there is a large amount of protruding fat, so even after repositioning, fat remains and the bulge under the eyes persists.

☆ Four reasons for dissatisfaction with fat repositioning ☆
① When there is not enough fat, the protruding area where fat existed may instead become sunken after fat repositioning
② When there is a large amount of fat, the original protruding area may still appear protruding even after fat repositioning
③ After fat repositioning, the original sunken area may instead appear protruded
④ When there is a small amount of fat, the original sunken area may not be properly filled even after fat repositioning and may still appear sunken and shadowed

Therefore, when performing fat repositioning, surgery should be done with careful consideration of the appropriate shape and indication in order to obtain a satisfactory result. If the case is not an indication for the procedure, fat repositioning may become an ambiguous operation that is neither one thing nor the other.

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

If the indications are not suitable, fat removal can provide a more certain result than fat repositioning, and if needed after fat removal, micro fat grafting can be performed to additionally fill sunken areas.

7. Problems with under-eye fat repositioning

① After fat repositioning, use the cold compress pack provided by the hospital for about 3 days.

② On the day of surgery, sleep with your head elevated about 30 degrees to reduce bruising and swelling.

③ On the day of surgery, avoid lying down as much as possible and sit up while going about your day to reduce swelling and bruising.

④ Washing your face and wearing makeup are possible starting the next day.

⑤ Contact lenses may be worn starting the day after surgery.

⑥ Use the eye drops prescribed by the hospital for about one week.

⑦ Since the conjunctiva is sutured with dissolvable thread, there is no separate suture removal.

⑧ Swelling and bruising are minor and will mostly subside in about one week.

Under-eye fat repositioning, when applied carelessly to patients who do not have much orbital fat, most often leads to unsatisfactory or unnatural results.

Also, with fat repositioning, improvement in under-eye color can hardly be expected; it can only be performed for the purpose of contour correction.

However, cases in which the desired flat under-eye area is actually created are extremely rare.

At other hospitals, there are many cases where fat repositioning is recommended even for eye areas with almost no visible bulging under-eye fat, and this should be considered carefully.

After under-eye fat repositioning, rather than becoming flatter, the under-eye area may become sunken or protruded, leading patients to contact our clinic for correction. In cases of sunken areas, correction with micro fat grafting is possible again.

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